Background to this inspection
Updated
18 June 2018
Dr Alma Sarajlic, also known as Staines Road Surgery, provides primary medical services in Twickenham to approximately 3000 patients and is one of 29 practices in Richmond Clinical Commissioning Group (CCG).
The practice population is in the third least deprived decile in England. The proportion of children registered at the practice who live in income deprived households is 13%, which is higher than the CCG average of 10%, and for older people the practice value is 14%, which is higher than the CCG average of 12%. The age profile of the patients registered at the practice is broadly the same as the CCG averages, with the majority of patients aged 15-44 years. Of patients registered with the practice, the largest group by ethnicity are white (78%), followed by Asian (13%), mixed (4%), black (3%) and other non-white ethnic groups (2%).
The practice is located on the ground floor of a newly refurbished premises and comprises a reception area, waiting room, four doctor consulting rooms, two nursing consultation rooms, a staff room and administrative offices. There are also patient toilets, including an accessible toilet.
The practice team at the surgery is made up of one full time female GP, one long-term locum GP, and one part time female healthcare assistant. At the time of the inspection the practice had a vacancy for a practice nurse, which was being temporarily filled by a locum nurse. The practice team also consists of a practice manager and reception/administrative staff.
The practice operates under a General Medical Services (GMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract).
The practice is open between 8:30am and 6.30pm Monday to Friday. Appointments are from 9am to 11:30am every morning, and 4pm to 6pm every afternoon apart from Wednesdays when there is no scheduled afternoon surgery (emergencies are seen when necessary). Extended hours surgeries are offered between 6:30pm and 7:15pm on Mondays and Thursdays. In total 9 GP sessions are available per week. Patients can also access appointments via the CCG seven-day opening Hub, which offers appointments from 8am until 8pm every day.
When the practice is closed patients are directed to contact the local out of hours service.
The practice is registered as a sole provider with the Care Quality Commission to provide the regulated activities of diagnostic and screening services; maternity and midwifery services; treatment of disease, disorder or injury; surgical procedures; and family planning.
Updated
18 June 2018
This practice is rated as Good overall. (Previous inspection August 2017 – Requires Improvement).
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Dr Alma Sarajlic (also known as Staines Road Surgery) on 17 April 2018. This inspection was carried-out to follow up on breaches of regulations identified at the previous inspection.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen; however, with regards to the storage of refrigerated medicines, a complete audit trail of the action taken when the fridge storing these medicines went outside of the recommended temperature was not always kept.
- When safety incidents did happen, the practice learned from them and improved their processes.
- The practice carried-out some reviews of the effectiveness and appropriateness of the care it provided; however, it did not always ensure that these reviews led to systemic improvements.
- During the previous inspection we had concerns about the practice’s failure to assure itself that all staff had received the training they required and remained competent to perform their role. We were informed that the practice was in the process of planning appraisals for the current year, which would include an assessment of competency where appropriate.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a commitment to continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
- Consider how staff can be effectively appraised to allow the provider to be assured of their ongoing competency, and ensure that the necessary assessments are completed and any identified training needs are met. Review and improve the arrangements in place for monitoring when staff training is due.
- Review the newly implemented Healthcare Assistant protocol to ensure that it accurately reflects the role and the safeguards in place to deliver a safe service.
- Review and improve the current arrangements for the storage of refrigerated medicines and make any necessary changes to ensure the risks identified are mitigated.
- Review and improve the arrangements in place for monitoring uncollected prescriptions.
- Continue to improve the uptake of childhood immunisations.
- Consider how the audit process could be developed to include routine review of clinical decision making, and to ensure systemic improvements are made to the service as a result of the audits undertaken.
- Display information about how to make a complaint in the practice and include contact details for the Parliamentary and Health Service Ombudsman in complaint response letters.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice