Archived: Dr Rajesh Kapur Also known as Narborough Health Centre

Updated 5 January 2017

Dr Rajesh Kapur is a single handed practice (supported by long term locums) which provides primary care services to approximately 2500 under a General Medical Services (GMS) contract.

• The practice is situated across two sites. Thornton Drive has a car park and is more accessible to disabled patients or those with poor mobility as it is all on the ground floor. Narborough Road has on street parking and a ramp to the front door however there are some clinics upstairs these are moved to downstairs if patients cannot manage the stairs.

• Services are provided from Thornton Drive, Narborough, Leicester, Leicestershire, LE19 2GX and 193 Narborough Road, Leicester, Leicestershire, LE3 0PE.

• The inspection team visited the Narborough Road site for the inspection.

• The practice consists of GP (male) who is assisted by two long term locums. (male and female).

• The nursing team consists of one practice nurse, one locum practice nurse and one health care assistant (HCA).

• The practice has a practice manager who is supported by four clerical and administrative staff to support the day to day running of the practice.The practice manager is also able to do phlebotomy.

• When the practice is closed patients are able to use the NHS 111 out of hours service.

• The practice has a higher than average number of patients aged 25 to 39 years of age.

• The practice has average deprivation and sits in the middle of the deprived centile.

• The practice is registered to provide the following regulated activities; surgical procedures; family planning, diagnostic and screening procedures, maternity and midwifery services; and treatment of disease, disorder or injury.

• The practice lies within the NHS East Leicestershire and Rutland Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

• The practice is open between 8am and 6pm Monday to Friday other than Thursday when Narborough Road closes at 1.30pm and Thornton Drive closes at 12.30pm. Appointments are available from 9am to 6pm with extended hours Tuesday 7am to 8am and Friday 6.30pm to 7pm at the Narborough Road site. GP appointments are available on the day and pre-bookable appointments can be booked up to four weeks in advance.

Updated 5 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rajesh Kapur on 24 November 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.
• Risks to patients were assessed and well managed.
• 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.

• Patient survey figures showed patients rated the practice lower than others for some aspects of care. The practice had made changes in relation to staffing to alleviate some of the patient concerns.

• Comments about the practice and staff were positive.

• 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.
• 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.

• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons.

• There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular meetings.

• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group had not met since February 2016.

• The practice had identified 25 patients as carers (1% of the practice list).

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.
• Complete any actions from Legionella and Fire risk assessment as required.
• Encourage PPG to become more active and re-introduce regular meetings.
• Enrol infection control lead on formal training for this role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 January 2017

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

• Nursing staff and GP’s had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was comparable to CCG and national averages. (87% compared to 93% CCG average and 90% national average).

• One of the GP’s leads with diabetes and provides insulin initiation in the practice.

• Longer appointments and home visits were available when needed.

Updated 5 January 2017

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 were in line with CCG averages for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 74%, which was similar to the CCG average of 79% and the national average of 76%.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 5 January 2017

The practice 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 worked at identifying patients at risk of hospital admission to reduce the risk and reduce the amount of unplanned admissions.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Reviews were completed in patients home were required.

• The practice worked with the multi-disciplinary teams in the care of older vulnerable patients.

Updated 5 January 2017

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 and flexible.

• The practice offered extended hours appointments one evening and one morning per week to facilitate access for working patients.

• Patients could book appointments on line, in person or on the telephone.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 5 January 2017

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

• 79% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 74% and the national average of 79%.

• 71% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was lower than the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

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

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

Updated 5 January 2017

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 register was monitored to ensure patients were attending for their annual reviews.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.