Archived: Dr D J Gandecha & Partners

Updated 7 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced desk based follow up inspection on 7 October 2016 to follow up concerns we found at Dr D J Gandecha & Partners on 5 April 2016. The ratings for the practice have been updated to reflect our findings following the improvements made since our last inspection in April 2016; the practice was now meeting the regulations that had previously been breached. At the inspection in April 2016 the practice was found to be requires improvement for providing safe services and for the care of people experiencing poor mental health. Following the most recent inspection we found that improvements had been made and that the practice was found to be good in providing safe services and for the care of people experiencing poor mental health. The overall rating of the practice did not change as the practice was previously rated as good.

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

• The processes for the proper and safe of management of medicines had been strenghtened. For example, there was a process for monitoring the use of prescription forms and pads and a system for the legal authorisation of healthcare assistants to administer medicines in place.

• There was a process to check the ongoing registration status with the appropriate professional body for GPs and nurses

• Mental capacity act training had been completed by clinicians.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 May 2016

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

• The practice nurse had lead roles in chronic disease management, including diabetes and asthma and regular reviews of patients with long-term conditions were carried out.

• All patients with a long-term condition had a care plan in place.

• Patients at risk of hospital admission were identified as a priority.

• Regular medication reviews were carried out to ensure correct medications were prescribed.

• A joint clinic with a GP and a member of the nursing team was available for patients with complex medical needs.

• Performance for most diabetes related indicators were similar to the national averages. However, monitoring of blood sugar levels was slightly below the national average (72% compared to 78%).

• Home visits were available when needed.

• The practice offered pneumococcal and flu vaccines.

Updated 31 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.

• We saw evidence that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The practice’s uptake for the cervical screening programme was 77%, which was higher than the CCG average of 69% and comparable to the national average of 74%.

• The practice provided a room for antenatal visits with the midwife so pregnant women could be seen at the surgery.
• Health visitor clinics were also held at the practice and postnatal services were available for new mothers.
• Contraception clinics were available and patients could be referred to the family planning clinics at St Peters Health Centre.

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

• An immunisation clinic was provided for children. Immunisation rates were higher than CCG rates for all standard childhood immunisations.

• Postnatal services were available at the practice, including 24-hour baby checks and 6-week baby checks.

• The practice offered whooping cough vaccines, as well as flu vaccines for children.

Updated 31 May 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.

• GPs worked with relevant health and social care professionals to deliver multi-disciplinary care to meet the needs of the patient.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. If appropriate, telephone consultations were also offered if a patient could not attend the practice and needed advice or guidance.

• Patients were referred to social services for help and support at home, as well as to occupational therapy for general mobility problems.

• The practice offered pneumococcal, shingles and flu vaccines.

Updated 31 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. For example, extended hours appointments were offered every day between 6.30pm and 7.30pm, except on a Thursday.

• The practice offered online services for repeat prescriptions and booking appointments.

• The practice offered NHS Health Checks as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 7 November 2016

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

At the inspection in April 2016 the were concerns relating to lack of training in the Mental Capacity Act.

Since that inspection staff had completed training and we saw certificates to show this had been completed.

Updated 31 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. Annual health reviews were offered to all patients with a learning disability.

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

• There was a system in place to register other vulnerable patients, including homeless people and travellers, to ensure they could be seen by a GP. The practice also liaised with The Dawn Centre in Leicester, which provided temporary accommodation for homeless people.

• The practice 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.