The Care Quality Commission
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Archived: Dr Gokaraju Arunaprasad

Overall: Good read more about inspection ratings

The Surgery, Patience Lane, Altofts, West Yorkshire, WF6 2JZ (01924) 890729

Provided and run by:
Dr Gokaraju Arunaprasad

All Inspections

27 April 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Gokaraju Arunaprasad (Patience Lane Surgery) on 28 September 2016. The overall rating for the practice was Good. However we rated the practice as Requires Improvement for providing safe services. The full comprehensive inspection report can be found by selecting the ‘all reports’ link for Dr Gokaraju Arunaprasad on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 27 April 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified in our previous inspection on 28 September 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as Good for providing safe services.

Our key findings were as follows:

  • The practice had developed a policy for Patient Group Directions (PGDs) and Patient Specific Directions which had been circulated to all staff. All relevant PGDs were in date, signed and accessible to users.

  • The practice had undertaken a full risk assessment of emergency drugs held in stock, and had purchased additional stock to supplement the medicines held.

  • Fire alarm tests were held weekly. A fire evacuation test had been carried out. Further fire drills were scheduled to be carried out at six monthly intervals.

    In addition we found:

  • The practice had developed clear systems and processes for the dissemination of MHRA bulletins, including identifying that any necessary actions or changes had been carried out.

  • The incident reporting system had been improved to include regular reviews of changes made or actions taken as a result of significant incidents.

  • The practice had evaluated the immunisations offered to staff, and all existing staff as well as new recruits were offered immunisation against Measles, Mumps and Rubella (MMR) and Varicella (chicken pox). Other vaccines were available for appropriate staff.

  • The practice had reviewed the systems in place to monitor and improve outcomes for patients. At the time of our visit the practice showed us they were beginning to participate in a local Improvement in Prescribing Plan (ImPP) looking at medicines optimisation audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Gokaraju Arunaprasad – Patience Lane Surgery on 28 September 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. However, we did not see evidence that actions identified as necessary following an incident had been implemented fully and that the reported event could be closed down.

  • Patient Group Directions (PGDs) within the practice had not been signed by the authorising manager and the principal GP was unaware of the PGD process, and specifically the need to authorise staff to administer these medicines.

  • Some risks to patients were assessed and well managed. Though fire drills/evacuations had not been carried out and fire alarm tests were not being carried out at regular intervals.
  • There was no formalised approach to the stocking of emergency medicines. The practice had not carried out a risk assessment with regard to emergency medicines they had not included in the GP’s bags or within the surgery.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • The practice had some systems, processes and practices in place to keep patients safe and safeguarded from abuse.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Data from the latest National GP Patient Survey showed the practice had high patient satisfaction scores.
  • Patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • The practice must ensure that Patient Group Directions are properly authorised, and that the authorising manager fully understands the process and gives the necessary level of scrutiny and oversight to this area of work.

  • The practice must hold fire drills/evacuations at suitable intervals and must re-instate weekly tests of the fire alarm system.

  • The practice must develop a formalised approach to the stocking of emergency medicines. In particular they must carry out a risk assessment with regard to emergency medicines they had not included in the GP’s bags or within the surgery.

The areas where the provider should make improvement are:

  • The practice should review the systems in place to assess, monitor and improve the quality and safety of services provided. Quality improvement activity linked to clinical audits was limited and did not achieve two complete cycles.

  • Review the immunity status of staff in relation to measles, mumps, rubella and chickenpox in order to assure themselves that their staff were adequately protected in line with the latest guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 July 2014

During a routine inspection

Dr Gokaraju Arunaprasad provides care for patients in the Altofts area near Normanton in the Wakefield CCG area.

During this inspection we looked at the  regulated activities the practice is registered for with the Care Quality Commission. They are the treatment of disease, disorder or injury; diagnostic and screening procedures; maternity and midwifery service and family planning.

The patients we spoke with and those who completed the CQC comment cards are complimentary about the care the practice provides. They feel staff treat them with dignity and respect.

We found the GP and staff listen to patient comments and take action to improve their service.

A range of appointments are available including consultations at the practice and telephone access to the GP. The GP provides home visits where required. Appointment booking was available on line, by telephone or in person.

The building is well-maintained and clean and good systems are in place which help ensure the building is regularly maintained and safe.

We saw robust risk assessment systems are in place, effective governance and clinical decisions followed best practice guidelines. The provider meets the regulations and provides services that are safe and effective.