The Care Quality Commission
  • Doctor
  • GP practice

Archived: Molla and Kesani

Overall: Inadequate read more about inspection ratings

Weston Favell Health Centre, Billing Brook Road, Northampton, Northamptonshire, NN3 8DW (01604) 409631

Provided and run by:
Molla and Kesani

All Inspections

21 May 2019

During a routine inspection

We carried out an announced comprehensive inspection at Molla and Kesani on 21 May 2019.

We last inspected this practice on 15 March 2016 when we rated the practice as Good.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as inadequate overall.

We rated the practice as inadequate for providing safe, effective, responsive and well-led services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • Safeguarding processes and procedures were inadequate.
  • Staff were not being safely recruited.
  • The practice did not have an adequate system in place to safely manage MHRA and other safety alerts.
  • Risks to staff and patients at the practice had not been adequately assessed, monitored and planned for.
  • There was limited monitoring of the outcomes of care and treatment.
  • The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
  • Cancer screening rates were significantly below national averages and the practice was failing to address this.
  • There was limited evidence in relation to how patients could feedback on how the practice was run.
  • The practice had not made the changes it needed to in order to respond to the needs of the patients who used the practice.
  • There was an absence of effective management at the practice which had impacted on the quality of care and treatment.
  • Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
  • The practice culture did not effectively support high quality sustainable care.
  • The overall governance arrangements were ineffective due to areas of risk which had not been identified prior to our inspection.
  • The practice did not have clear and effective processes for managing risks.

We rated the practice as requires improvement caring services because:

  • There was limited evidence in relation to how patients could feedback on how the practice was run.
  • The feedback received as part of the inspection was positive, however, the systems were not in place to accurately assess patient’s experiences and act on them.
  • The practice had not implemented suitable measures to ensure patients could communicate effectively with health professionals where language may have been a barrier for them.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure sufficient numbers of skilled and experienced staff are employed at the practice to deliver safe care and treatment.
  • Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

The areas where the provider should make improvements are:

  • Improve the uptake of patients for the national cancer screening programme.
  • Reduce the exception reporting at the practice.

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.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

15 March 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Molla and Kesani’s practice on 15 March 2016. Overall the practice is rated as good although the safe domain requires improvement.

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 the systems for dealing with safety alerts and patients on specific medications should be reviewed to make them more robust.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Patients said they could get an appointment with a GP, but sometimes experienced difficulties. They reported that there was continuity of care, with urgent appointments available the same day.
  • The practice had adequate facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively 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 improvement are:

  • Improve the system for dealing with safety alerts to ensure there is evidence that appropriate actions are always taken and discussed at practice meetings.
  • Implement a system for ensuring the follow up of children who do not attend hospital appointments.
  • Improve the system in place to ensure that all patients on medicines which require monitoring have the appropriate tests prior to prescribing.
  • Continue to implement the carers strategy and develop a more accurate register of carers.
  • Consider displaying a poster showing patients how to complain.
  • Continue to try to re-establish the patient participation group and address the lower than average satisfaction scores in the national patient survey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice