Dr Surakshan Claude Seimon Also known as Mandeville Medical Centre

Updated 1 June 2016

Dr Surakshan Claude Seimon also known as Mandeville Medical Centre is situated at 3 Mandeville Road, Northolt, Ealing, UB5 5HB. The practice provides NHS primary care services through a Personal Medical Services (PMS) contract to approximately 5,300 people living in the Northolt area of the London Borough of Ealing. The practice is part of the NHS Ealing Clinical Commissioning Group (CCG).

The practice population has a higher than national average number of patients between 25 and 40 years and children under nine years of age. The ethnicity of the population is predominantly white British. There is also a transient population of eastern Europeans, Africans and Nepalese. The practice area is rated in the fourth most deprived decile of the Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder or injury and maternity and midwifery services.

The practice team consists of a male principal GP (eight sessions), a female GP (six sessions), a regular locum GP (two sessions) three practice nurses, phlebotomist, practice manager and a small team of reception / administration staff.

The practice is open between 8.00hrs and 18.30hrs Monday to Friday apart from Wednesday where the practice closes at 13.30hrs. The telephone lines open at 8.00hrs daily. Appointments are available from 8.30hrs to 12.00hrs every morning and 15.30hrs to 18.00hrs daily. The practice does not provide extended surgery hours however weekend appointments are provided by the local GP federation. For out-of-hours (OOH) care including Wednesday afternoons, patients are instructed to contact the NHS 111 service where they are directed to local OOH services.

Services provided include chronic disease management, child and travel vaccinations, phlebotomy, care planning, simple & complex wound care, dementia checks, ECG and spirometry.

Updated 1 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 8.00hrs on 19 April 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 although there was no risk assessment for the Control of Substances Hazardous to Health (COSHH).
• 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. However, basic life support training had not been updated annually for all staff.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice identified and supported patients who were also carers, however only seven carers had been identified.
• 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.
• Patients said they could make an appointment with a named GP in a reasonable time and there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice 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 should make improvements are:

• Carry out a risk assessment for the Control of Substances Hazardous to Health (COSHH).
• Ensure basic life support training is updated annually for all staff.
• Formalise staff induction programmes.
• Take action to proactively identify and support patients who are also carers.
• Advertise translation services in the patient waiting area.
• Consider improving communication with patients who have a hearing impairment.
• Develop a formal strategy to deliver the practice vision.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 June 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practices Quality and Outcomes Framework (QOF) performance for diabetes related indicators was 93%, which was an improvement on the previous years achievement of 80%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review 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.

Updated 1 June 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 were comparable to others 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.
• The percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding five years was 81%, which was in line with the national average.
• The premises were suitable for children and babies.

Updated 1 June 2016

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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice engaged in the unplanned admissions enhanced service to reduce unnecessary hospital admissions for older people.

Updated 1 June 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 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.
• Extended surgery hours were available through the local GP federation.

Updated 1 June 2016

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

• 80% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 96%, which was above 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.
• 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.

Updated 1 June 2016

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

• 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.
• 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 regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.