Dr Manoj Maini Also known as Desford Medical Centre

Updated 16 May 2016

Dr Manoj Maini, also known as Desford Medical Centre, is a GP practice providing primary medical services to around 4,211 patients within the Hinkley and Bosworth area. West Leicestershire Clinical Commissioning Group (WLCCG) commission the practice’s services.

The service is provided by a senior GP (male) and two female salaried GPs. There is a nursing team comprising of a locum practice nurse and a healthcare assistant. A practice manager and a team of reception and administration staff support them.

The practice is located within a single-storey building and all patient facilities are easily accessible.

The practice is open from 8am to 6.30pm Monday to Friday. Appointments are available between 8.30am and 11am and 3.3pm and 6pm. Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest walk-in centre to treat minor illnesses and injuries, as well as accident and emergency departments.

Updated 16 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Manoj Maini on 02 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had developed protocols on the patient record system as a result of new guidelines, the system then alerted GPs to carry out certain tests for specific medical conditions.

• There was an effective system in place for reporting and recording significant events and staff were aware how to report an incident. However, a summary of significant events was not maintained to identify potential trends.

• Detailed discussions were held to ensure lessons were learnt and shared, however minutes did not always record who was responsible for agreed action points and when they should be completed by.

• There were embedded systems in relation to obtaining, prescribing, recording, handling, storing and security of medicines.

• Data from the Quality and Outcomes Framework showed patient outcomes were average compared to the national average. The practice had high exception reporting in some clinical areas, however had investigated the reasons for exception reporting and taken action.

• Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs. This included the community matron, integrated care co-ordinator, district nurse and LOROS (a county based charity specialising in hospice care for persons over the age of 16).

• Referrals through the choose and book system were made during a patient consultation and GPs completed the referral template with the patient.

• Data from the National GP Patient Survey showed patients rated the practice higher than others for several aspects of care.

• Patients said they were very satisfied with the care and treatment received and staff treated them with dignity and respect.

• The practice supported patients and carers emotionally with their care and treatment and signposted them to relevant support groups as required.

• The practice engaged with the NHS England Area Team and Clinical Commissioning Group to review the needs of the local population and participated in service improvements and local initiatives. For example, utilising the local area co-ordinator to ensure patients social care needs were also cared for.

• Patients told us they found it easy to make an appointment with a GP and nurse.

• Information about how to complain was available in the patient waiting area. However, aspects of the complaints procedures was not in line with recommended guidance.

• The practice had a clear vision to support the delivery of good quality care and staff were aware of their roles to achieve the vision.

• There were arrangements for identifying, recording and managing risks. Actions were carried out to mitigate potential risks.

• There was a clear leadership structure in place and staff felt supported by management.

• There was an active patient participation group which met on a regular basis and assisted with health promotion. The practice acted on feedback from the group and also feedback from patients and staff.

• The provider was aware of and complied with the requirements of the Duty of Candour. The partners encouraged a culture of openness and honesty.

The areas where the provider should make improvements are:

• Maintain a summary of significant events to identify trends.

• Record when agreed actions should be completed by within meetings.

• Ensure annual registration with professional bodies, for instance General Medical Council and Nursing and Midwifery Council, are checked for all clinical staff.

• Ensure complaints procedures and policies are in line with recommended guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 May 2016

The practice is rated as requires improvement for the care of people with long-term conditions.

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice had higher than average exception reporting (where the practice had removed patients from QOF calculations) in relation to patinets with long-term conditions. Work had been carried out to identify the reasons for this and the practice took relevant action.

• Performance for diabetes related indicators, for example monitoring of blood sugar levels, was better compared to the national average. 86% compared to 78%.

• The practice offered longer appointments and home visits to those that needed it.

• A structured annual review was carried out to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care, for instance heart failure service.

• A diabetes nurse specialist provided a monthly clinic for complex diabetic patients.

• A chronic kidney disease (CKD) nurse specialist attended the practice to maintain the CKD register of patients.

Updated 16 May 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Immunisation rates for the standard childhood immunisations were mixed. For example,

• 80% of patients diagnosed with asthma had an asthma review in the last 12 months. This was slightly higher than the national average of 75%.

• The practice’s uptake for the cervical screening programme was 83%, which was comparable to the CCG average of 78% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice provided a room for antenatal visits so pregnant women could be seen at the surgery.

• The practice offered contraception services, including the insertion and removal of contraceptive implants.

Updated 16 May 2016

The provider is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent on the day appointments.

• Those at high risk of hospital admission and end of life care needs were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care.

• Those identified as high risk had a care plan in place and multi-disciplinary meetings were held on a monthly basis to discuss ongoing needs.

• The practice referred patients to the local area co-ordinator who was able to identify specific social needs and make appropriate referrals to relevant services.

• Two GPs had completed a frailty course to assist with the identification of conditions of frailty and implement early interventions.

Updated 16 May 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice offered online services to book appointments and order repeat prescriptions.

• Health promotion advice was offered during consultations and a range of accessible health promotion material was available in the patient waiting area.

• Telephone consultations were also available.

Updated 16 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 79% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, compared to 84%.

• 100% of those with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, compared to 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. This included working closely with and making referrals to the mental health facilitator.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• Longer appointments were available for patients who needed additional support from the GP.

Updated 16 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• Same day appointments were available for patients from the travelling community.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and ensured regular reviews and care plans were in place.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities and knew how to contact relevant agencies in normal working hours and out of hours.

• All staff had received training in safeguarding vulnerable adults and children.

• The practice referred patients to the local area co-ordinator who was able to identify specific social needs and make appropriate referrals to relevant services.