Archived: Dr Surinder Sennik Also known as Briset Corner Surgery

Dr Surinder Sennik also known as Briset Corner Surgery is a provider registered with CQC. We carried out this announced comprehensive inspection on 22 January 2020 to follow up concerns raised at our inspection on 22 May 2019. Breaches of legal requirements were found, a requirement notice, and warning notice were issued in relation to patient safety, staffing and governance.We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as inadequate overall and for the safe, effective and well-led key questions. The caring key question was rated requires improvement and the responsive key questions were rated as good.

The reports of all the previous inspections can be found by selecting the ‘all reports’ link for Dr Surinder Sennik on our website at www.cqc.org.uk.

We rated the practice as inadequate for providing safe services because:

• The provider had not ensured that staff had received safeguarding training appropriate for their role.
• The practice did not have an effective system in place to manage safety alerts.
• The systems in place to monitor patients prescribed medicines for long term conditions, including high risk medicines, were not effective.

We rated the practice inadequate for providing effective services:

• There was no evidence of the practice carrying out quality improvement activity.
• The provider had not taken steps to ensure staff had the skills, knowledge and experience to carry out their roles.
• There was limited monitoring of the outcomes of care and treatment.
• The practice’s 2018/19 quality outcomes framework performance was below local and national averages in several indicators.

We rated the practice inadequate for providing well-led services because:

• Patients’ treatment was put at risk due to lack of adherence to best practice guidance, and lack of consideration for the potential treatment needs of patients.
• The practice had not established effective systems to monitor the quality of services provided and to mitigate risks to patients.
• We saw no evidence of the practice carrying out quality improvement to improve patient outcomes or learning and reflective practice.

We rated the practice requires improvement for providing caring services because:

• Data from the GP Patient survey was below local and national averages.
• The practice had taken minimal action on the results of their internal patient survey.
• The practice had identified less than 1% of patients as being a carer.

We rated the practice good for providing responsive services because:

• Data from the national GP patient survey showed patients rated the practice in-line with other practices for all aspects of making an appointment at the practice.
• In the main, the service organised and delivered services to meet patients’ needs. It took account of patient needs and preferences. However, there was an area which requires improvement.

We considered enforcement action but as the provider had resigned with effect of 31 March 2020, we decided not to take further action.

Had the practice remained open we would have said they must:

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Undertake an assessment of how significant events incidents can be identified, recorded and analysed for improvements.
• Undertake a review of patients views of the accessibility of the practice nurse.
• Revise the approach to managing patient referrals to ensure they are completed in a timely manner.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP Chief

Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Dr Surinder Sennik, also known as Briset Corner Surgery on 22 May 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions, following concerns raised. This report covers our findings in relation to those requirements. The practice was rated as requires improvement overall and for the safe, effective and caring key questions. The responsive key question was rated as good and the well-led key question was rated as inadequate.

Breaches of legal requirements were found, a requirement notice, and warning notice were issued in relation to patient safety, staffing and governance.

The reports of all the previous inspections can be found by selecting the ‘all reports’ link for Dr Surinder Sennik on our website at www.cqc.org.uk.

We have rated this practice as requires improvement overall and requires improvement for all population groups due to significant issues affecting all these groups.

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected
• Information from our ongoing monitoring of data about services and;
• Information from the provider, patients and the public.

We rated the practice as inadequate for providing well-led services because:

• There was a lack of governance arrangements to ensure that quality assurance processes were in place which led to improvements in patient outcomes.
• The practice culture did not effectively support high-quality sustainable care.
• The overall governance arrangements were ineffective.
• The practice did not have clear and processes for managing risks, issues and performance.

We rated the practice as requires improvement for providing safe services because:

• At the time of inspection, the practice did not stock the full list of suggested emergency medicines.
• The practice did not have clear and effective processes for managing risks, issues and performance.
• Not all staff had training in safeguarding, fire safety and infection control.
• The provider had not ensured appropriate recruitment checks had been carried for all staff.
• Not all staff had evidence of their immunisation status on file.

We rated the practice as requires improvement for providing effective services because:

• The provider had not taken steps to ensure all staff had the knowledge to carry out their roles.
• There was no evidence of the practice reviewing processes in place to ensure activities resulted in quality improvements other than activities directed by the clinical commissioning group.

We rated the practice as requires improvement for providing a caring service because:

• Data from the GP Patient survey showed that the practice was below local and national averages in areas such as feeling treated with care and concern.
• The practice had identified less than 1% of the patients as being a carer.

We rated the practice as good for providing a responsive service because:

• Data from the national GP patient survey showed patients rated the practice in-line with other practices for all aspects of making an appointment at the practice.
• People’s needs, and preferences were considered and acted on to ensure that services are delivered in a way that was convenient.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care