The Care Quality Commission
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  • GP practice

Archived: Dr Latif Hussain Also known as Milehouse Medical Practice

Overall: Requires improvement read more about inspection ratings

Milehouse Primary Care Centre, Lymebrook Way, Newcastle Under Lyme, Staffordshire, ST5 9GA (01782) 663830

Provided and run by:
Dr Latif Hussain

Important: The provider of this service changed. See new profile

All Inspections

10 January 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Latif Hussain on 18 October 2016. Breaches of legal requirements were found and a warning notice was served for Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Good Governance.

A warning notice was served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Good Governance.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Latif Hussain on our website at www.cqc.org.uk.

We undertook a focused follow up inspection on 10 January to check that the practice had taken urgent action to ensure they met the legal requirements of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Good Governance. This report only covers our findings in relation to the warning notice. A follow up inspection will be carried out within six months to check that the practice had followed their action plan for the other issues identified at the previous inspection and to confirm they meet legal requirements.

Our key findings were:

The practice had responded positively to the warning notice and had effectively addressed all of the previously identified shortcomings.

  • The practice had developed an audit policy and a schedule of planned audits. We saw evidence of four audits completed since the last inspection. There was a schedule in place to complete the audit cycle for each one.

  • There was a new process in place to monitor patients on high risk medicines and we saw how the practice followed the policy to ensure that these patients were kept safe.

  • The practice had introduced a new process to ensure that patient safety alerts from third parties were effectively acted upon.

  • We saw evidence that the practice was implementing and monitoring the use of best practice guidance and standards, including National Institute for Health and Care Excellence (NICE) guidance.

  • The practice was communicating effectively with other services about the care and treatment of vulnerable patients when the practice was closed.

  • The practice had introduced a system to monitor and manage uncollected prescriptions.

  • There was an up to date safeguarding policy in place.

  • The practice business plan had been reviewed and updated since our last inspection.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Latif Hussain on 4 August 2015. After the comprehensive inspection, the practice was rated as requires improvement. Improvements were required to ensure the employment of fit and proper persons.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dr Latif Hussain on our website at www.cqc.org.uk.

We undertook an announced comprehensive inspection on 18 October 2016 to check that the practice now met legal requirements. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Learning was shared with staff and reported to external agencies when required.

  • Required recruitment checks had been made before a member of staff was employed to work at the practice. However, the physical and mental health of newly appointed staff had not been considered.

  • Effective systems had not been put in place to mitigate risks to patients who took high risk medicines.
  • An overarching training matrix and policy had been put in place to monitor that all staff were up to date with their training needs and received regular appraisals.

  • Patient feedback was overwhelmingly positive about the sit and wait appointment system. Data from the National Patient Survey published in July 2016 showed that 96% of respondents described their experience of making an appointment as good.

  • Feedback from patients about their care was consistently positive and was reflected in the national patient survey published in July 2016.
  • The practice had reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group (CCG) to secure improvements to services where these were identified. For example, the practice had carried out a re-audit of A&E attendances and shared their findings with the local CCG to inform the development of future services.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
  • The practice had a vision which was to provide safe, effective and high quality primary care to their practice population. However, the practice did not have a supporting business plan that reflected this vision to ensure the future direction of the practice was monitored and evaluated.
  • The practice had visible clinical and managerial leadership but governance and audit arrangements were not effective.

The areas where the provider must make improvement are:

  • Implement a formal system to log, review, discuss and act on alerts received that may affect patient safety.

  • Implement effective systems to mitigate risks to patients who take high risk medicines.

  • Implement an effective system for the management of uncollected repeat prescriptions to ensure patients with long term conditions receive the treatment they require.

  • Implement effective governance and audit systems to mitigate risks and improve the quality of the service provision.

  • Implement a system to ensure that information is shared with the out of hours service for patients nearing the end of their life or if they had a ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) plan in place.

The areas where the provider should make improvement are:

  • Implement processes to demonstrate that the physical and mental health of newly appointed staff have been considered to ensure they are suitable to carry out the requirements of the role.

  • Mitigate risks identified in arrangements to take appropriate action in the event of a medical emergency by ensuring that all staff are aware of where the automated external defibrillator is located.

  • Develop a business plan to ensure the future challenges and direction of the practice are monitored and evaluated.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by the CQC that a service has to improve within six months to avoid the CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

4 August 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Dr. Latif Hussain practice, also known as Milehouse Medical Practice, is located in Newcastle Under Lyme, Staffordshire. We carried out an announced comprehensive inspection on 4 August 2015. Overall, Dr. Latif Hussain practice is rated as requires improvement.

Specifically, we found the practice to be good in caring, effective and responsive and requires improvement in safe and well led. It was also rated as requires improvement for providing services for all the population groups.

Our key findings were as follows:

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
  • Patients’ needs were assessed and care was planned and delivered after considering best practice guidance.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure they met patients’ needs.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
  • The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • Most formal governance arrangements were in place with a few exceptions for example, a lack of a training policy, and no planner or matrix system in place to be assured that all staff were up to date with their training needs.

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

Importantly, the provider must:

Ensure recruitment arrangements include all necessary pre-employment checks and that appropriate records are held for all staff.

The provider should:

Ensure that disease modifying medicine prescribing processes including sight of patients’ blood results are documented and any risks identified are mitigated between the prescriber and rheumatology department.

Ensure staff have a regular appraisal.

Consider a reaudit in respect of the high numbers of A & E attendances when compared with national figures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

30 April 2013

During a routine inspection

On the day of our announced inspection we spoke with five patients and four members of staff. We had also spoken to a spokesperson from the patient participation group. One patient told us, 'The staff are always polite and chirpy'. Another patient told us, 'Treatments are always discussed fully with me and I leave knowing what has been said'.

We saw that patient's views and experiences were taken into account in the way the service was provided and that they where treated with dignity and respect. When patients received care or treatment they were asked for their consent and their wishes were listened to.

Staff had received training in safeguarding children and vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to ensure that patients were protected from harm. Patients were cared for in a clean, hygienic environment.

We saw that medicines were stored safely but there were no systems in place to monitor medicines stock control. The practice had an effective system to regularly assess and monitor the quality of the rest of the service that patients received.