13 March 2019
During a routine inspection
- GP practice
Archived: Dr Abhijit Neil Banik Also known as Park Farm Surgery
All Inspections
06/07/2018
During an inspection looking at part of the service
We carried out an announced comprehensive inspection at Dr Abhijit Neil Banik on 28 February 2018. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. Warning Notices were served in relation to breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 12 Safe care and treatment and Regulation 17 Good governance found at this inspection. The full comprehensive report on the February 2018 inspection can be found by selecting the ‘all reports’ link for Dr Abhijit Neil Banik on our website at .
After our February 2018 inspection the practice wrote to tell us how they would make the necessary improvements to comply with the Warning Notices.
We undertook an announced focused inspection on the 6 July 2018, to confirm that the practice had carried out their plans to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 28 February 2018. This report only covers findings in relation to those requirements. The practice was not rated as a consequence of this inspection.
At this inspection we found:
- Not all the improvements required by the warning notices had been complied with.
- The practice had made some improvements to their safeguarding systems. However, not all the necessary requirements had been met.
- The system for recording, analysing, acting on and learning from significant events had not significantly improved since our February 2018 inspection.
- Not all of the systems and processes to manage infection prevention and control were being effectively implemented.
- The system for recording, analysing, acting on and learning from complaints had not improved since our November 2017 inspection.
- The systems of accountability to support good governance and management had not sufficiently improved since our February 2018 inspection.
The areas where the provider must make improvements as they are in breach of regulations are:
Importantly, the provider must:
- Ensure care and treatment is provided in a safe way to patients.
- Ensure systems and processes to ensure good governance in accordance with the fundamental standards of care are effective.
As our inspection on 6 July 2018 found that the practice had not fully met the Warning Notice issued on 12 April 2018 further Warning Notices were served in relation to breaches of:
The Health and Social care Act 2008 (Regulated Activities) Regulations 2014:
- Regulation 12 Safe care and treatment
- Regulation 17 Good governance.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Another inspection will be conducted within six months, and if there is not enough improvement we will move to close the service.
Special measures will give people who use the service the reassurance that the care they get should improve.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
28 February 2018
During a routine inspection
We carried out an announced comprehensive inspection at Dr Abhijit Neil Banik on 28 February 2018. This practice is rated as Inadequate overall. (At our previous inspection on the 19 January 2016 this practice was rated requires improvement overall and at our follow up inspection on the 14 September 2016 the practice was rated as good)
The key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires Improvement
Are services caring? – Good
Are services responsive? – Requires Improvement
Are services well-led? - Inadequate
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Inadequate
People with long-term conditions – Inadequate
Families, children and young people – Inadequate
Working age people (including those retired and students – Inadequate
People whose circumstances may make them vulnerable – Inadequate
People experiencing poor mental health (including people with dementia) - Inadequate
We carried out an announced comprehensive inspection at Dr Abhijit Neil Banik on 28 February 2018 as part of our inspection programme.
At this inspection we found:
- The practice did not have clear systems to identify and manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice did not have an effective system to record or share learning from them.
- The practice did not maintain appropriate standards of cleanliness and hygiene.
- Staff were aware of current evidence based guidance. The practice could demonstrate how they ensured role-specific training and updating for relevant staff, with the exception of immunisation and vaccination updates for the practice nurse and for all locum GPs employed directly by the practice.
- Patients’ needs were fully assessed. This included their clinical needs and their mental and physical wellbeing.
- Staff treated patients with compassion, kindness, dignity and respect.
- Patients said they found it easy to make an appointment (telephone or face to face) with the GP and that there was continuity of care, with urgent appointments available the same day. If there were no suitable appointments at the practice patients were referred to the Queen Victoria Hospital hub in Folkestone who provide GP appointments between 8am and 8pm.
- The patient participation group was not active at the time of the inspection.
- The practice had a range of governance documents to support the delivery of good quality care. However, we found that governance arrangements were not effectively implemented nor were staff always able to access them.
- The systems and processes for learning and continuous improvement were not used effectively to identify risks and areas for improvement.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.
- 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.
The areas where the provider should make improvements are:
- Review safeguarding systems to help ensure staff and locums have access to relevant safeguarding information and contact details.
- Review the systems and processes for managing childhood immunisations to help ensure the national childhood vaccination programme targets are met.
- Review patient information to help ensure they are relevant and up to date.
- Review the system for sharing the Medicines and Healthcare products Regulatory Agency (MHRA) alerts across the practice staff team.
- Review the process for clinical audits to help ensure they are improving patient outcomes.
- Review how the practice canvasses patient feedback on services provided via a patient participation group.
- Review national patient survey results and target improvements to national average.
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.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
14 September 2016
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 Abhijit Neil Banik on 19 January 2016. Breaches of the legal requirements were found. Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches.
We undertook this focussed inspection on 14 September 2016, to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting ‘all reports’ link for Dr Abhijit Neil Banik on our website at www.cqc.org.uk.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
19 January 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Abhijit Neil Banik (also known as Park Farm Surgery) on 19 January 2016. Overall the practice is rated as requires improvement.
Our key findings across all the areas we inspected were as follows:
- Some staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, not all staff knew what constituted a significant event and were not aware of the practice’s significant event policy.
- Risks to patients were assessed and generally well managed. However, there are areas for improvement. For example, the security of clinical waste.
- Data collected from the Quality and Outcomes Framework showed patient outcomes were better than local and national averages. Audits had been carried out and were driving improvement in performance to raise patient outcomes.
- Urgent appointments were available on the day they were requested.
- The practice had a number of policies and procedures to govern activity, but not all of the policies or risk assessments contained a date, signature or review date.
- The practice had sought feedback from patients and had an active patient participation group.
- Some aspects of care in the National GP Patient Survey 2015 were below national and local averages. However, patients we spoke with during the inspection told us they were treated with compassion, dignity and respect
We saw one area of outstanding practice:
- The practice provided outstanding care for patients with long term conditions such as Chronic Obstructive Pulmonary Disease. The GP was the chair of the Chronic Obstructive Pulmonary Disease (COPD) task force for the South Kent Clinical Commissioning Group and was leading in developing care pathways and training for local GP practices in COPD care.
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Ensure the environmental cleaning and decontamination policy specifies how to clean all areas, fixtures and fittings. Provide and maintain a clean and appropriate environment in managed premises that facilitates the prevention and control of infections.
- Ensure there are formal governance arrangements so that policies are reviewed, dated and signed and staff are aware of how these operate.
- Ensure the lock for clinical waste storage is used effectively.
- Ensure oxygen cylinders have an expiry date displayed and retesting to demonstrate they are safe.
In addition the provider should:
- Revise the system that identifies patients who are also carers to helpensure that all patients on the practice list who are carers are offered relevant support if required.
- Regularly review and date risk assessments for responding to a medical emergency in line with national guidance.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
During a check to make sure that the improvements required had been made
10 January 2014
During a routine inspection
We saw that, on arrival for an appointment, the receptionist greeted patients by their names as they registered their attendance so that clinical staff knew they were there.
Patients told us the staff treated them respectfully and were helpful. We saw that staff spoke politely to patients and consultations were carried out in private treatment rooms.
Information was clearly displayed for people, including health promotion, access to support services and information about the practice and the services provided.
We found evidence that staff had received regular training, supervisions and appraisals. We looked at the quality monitoring systems used within the surgery. We saw these to be effective, with evidence of learning from areas identified through audit and monitoring. For example; the surgery held frequent meetings with staff and other health care providers. The surgery had complaints policies and procedures in place to deal appropriately with any issues raised. However, patients were not protected from the risk of infection because appropriate guidance had not been followed.
Patients were not protected from the risk of infection because appropriate guidance had not been followed.