• Doctor
  • GP practice

Archived: Family Healthcare Centre

Overall: Requires improvement read more about inspection ratings

1 East Anglian Way, Gorleston-on-Sea, Great Yarmouth, Norfolk, NR31 6TY 0844 477 8929

Provided and run by:
Dr Keivan Maleki

All Inspections

14 September 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Family Healthcare Centre on 14 September 2015. This followed an inspection in October 2014 that placed the practice into special measures due to its rating of inadequate. The outcome of this inspection has identified that the practice is now rated as requires improvement.

Specifically, we found the practice to require improvement for providing safe, effective, responsive and well led services. It also requires improvement for providing services for older people, people with long-term conditions, families children and young people, working age people (including those recently retired) and people experiencing poor mental health (including people with dementia). It was good for providing a caring service to patients.

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

  • Most areas of risk associated with the safe running of the service were managed safely although some areas still required improvement such as legionella management and complaints.
  • Patients said they were treated with dignity, kindness and respect and they were involved in their care and decisions about their treatment.
  • Patients told us they sometimes had difficulty arranging an appointment although urgent appointments were usually available on the day they were requested.
  • The practice was visibly clean and they had improved systems to ensure that safe infection prevention and control procedures were being followed.
  • Staff told us that communication within the practice had improved and they valued being part of a team.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Ensure that systems are in place to manage and monitor risks to the quality and safety of the service in relation to legionella management and risks to the continuity of the service.
  • Ensure that the incident reporting procedure is followed by staff at all times.
  • Non -clinical staff who act as a chaperone must receive appropriate training and a risk assessment so that an appropriate level of criminal records check is completed before they undertake the role
  • Ensure that patient information received from specialist services are accurately recorded in the electronic records so that medicines are safely and accurately prescribed.
  • Ensure that records are maintained to demonstrate that appropriate staff are employed by the practice.
  • Improve the complaints process so that all complaints are managed in a timely way and in accordance with the policy so that learning is shared and actioned.

In addition the provider should:

  • Make information available to patients about chaperones on the practice’s website.
  • Include guidelines in the recruitment policy on which staff roles require a check with the Disclosure and Barring Service.
  • Develop care plans for all patients at high risk of unplanned admissions to hospital.
  • Ensure audits of the completeness of clinical records are in place

On the basis of the ratings given to this practice at this inspection, we are removing this provider from special measures. We will inspect the practice again to ensure that it continues to make improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

This is the report for Dr Keivan Maleki at The Family Health Care Centre, following our planned comprehensive inspection visit that took place on 28 October 2014.

The practice is registered with the Care Quality Commission to provide primary care services. During this inspection we spoke with patients, staff and the practice management team.

The practice is rated as inadequate. Although the practice staff offered a caring and supportive service, there were very limited systems in place to monitor the safety and effectiveness of the care and support that was being provided to patients. The leadership and management structure were not clear.

Our key findings were as follows:

  • Patients told us they received a good service from the staff who were helpful, friendly and supportive
  • Patients could access an appointment although this was not always with their preferred GP. The practice had been unable to recruit permanent GPs to this single-handed GP practice and this placed many demands on the lead GP.
  • The leadership structure and the systems used to monitor the safety and quality of the service were not sufficient to protect patients against the risks of unsafe care and treatment.

There  were several areas of practice where the provider needs to make improvements

Importantly, the provider must:

Develop a clear management and leadership structure.

Ensure that systems to monitor the quality of the service are established so that learning and improvement takes place through the use of the following:

  • an audit plan that includes regular clinical audits.
  • an effective process for identifying, reporting and investigating significant events, incidents and complaints
  • Effective recruitment and induction procedures
  • An appraisal system, training plan and any relevant support for staff so that their development and competence can be monitored.
  • A process to ensure that national best practice guidelines are followed.
  • A process should be in place to monitor and support the maintenance of equipment.

The practice must ensure that medicines are safely stored and fit for use.

The practice must strengthen the clinical leadership for infection control and seek assurance that the quality of cleaning at the practice is being maintained. This must also include monitoring progress with actions following external audits in a timely way. Surgical procedures must be reviewed so that best practice guidelines are followed and there is a system in place to follow up patients post procedure. The practice must maintain an up to date list of clinical staff with Hepatitis B immunity.

In addition the provider should:

  • review and strengthen the arrangements for the multidisciplinary meetings.
  • seek assurance that the quality of cleaning at the practice is being maintained and that action plans following external infection control checks are progressed in a timely way.
  • work more effectively with the patient participation group.
  • ensure that staff are familiar with whistleblowing procedures.
  • Review the consent policy to include reference to the Mental Capacity Act 2005 and ensure that staff are knowledgeable in its' use.  
  • Ensure that staff training plans include relevant fire safety training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice