The Care Quality Commission
  • Doctor
  • GP practice

Archived: The Surgery

Overall: Good read more about inspection ratings

43 East View, Boldon Colliery, Tyne and Wear, NE35 9AU (0191) 537 3202

Provided and run by:
Dr Somesh Chander

All Inspections

7 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a previous announced inspection of this practice on 23 June 2015. Breaches of legal requirements were found. Overall, we rated the practice as requires improvement. After the comprehensive inspection the practice wrote to us to say what they would do to meet the legal requirements set out in the Health and Social Care Act (HSCA) 2008.

We undertook this comprehensive inspection to check that the practice had followed their plan and to confirm that they now met legal requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Somesh Chander on our website at www.cqc.org.uk.

Overall, the practice is rated as good.

Our key findings 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.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had improved access to training to provide them with 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.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice had taken action to address the concerns raised at their previous CQC inspection. They had developed a clear vision, strategy and plan to deliver high quality care and promote good outcomes for patients.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The systems they had in place for learning from significant events were satisfactory and showed evidence of continuous improvement. They had showed continuous improvement in the way they addressed the concerns raised at their previous CQC inspection, which took place in June 2015.

There were also areas where the practice should make improvements. The practice should:-

  • Review the arrangements for cleanliness and infection control at the branch surgery to ensure they are effective and to protect patients and staff from the risks associated with healthcare infections.
  • Review their approach to audit to ensure there is a closer link between choices of audit topic and improving outcomes for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

23 June 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the provider Dr Somesh Chander on 23 June 2015. Overall, the practice is rated as requires improvement.

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

  • The arrangements for governance and performance management did not always operate effectively.
  • Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses. Although the practice reviewed when things went wrong, lessons learnt were not communicated and so safety was not improved. They could not demonstrate to us they had used reviews of significant events and other incidents and complaints to ensure they improved outcomes for patients.
  • Patients were at risk of harm as weaknesses in practice systems and processes did not ensure patient safety. For example, the practice did not have appropriate equipment in place to provide treatment to patients in a medical emergency. The recruitment processes were not safe. There were no assurance systems in place to confirm cleanliness and infection control procedures were effective.
  • The practice had scored 91.0% for the year 2013/14 on clinical indicators within the quality outcomes framework (QOF). Although slightly below, this was in line with both the local Clinical Commissioning Group (CCG) and England averages.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • Patients said they were treated with compassion, dignity and respect and that they were involved in decisions about their care and treatment;
  • Patients said they found it easy to make an appointment and urgent same-day access was available;
  • The practice had recently identified staff training was not well structured, and this had led to gaps in training programmes for staff. They had identified improvements to the mandatory training programme and appraisal process to address this.

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

Importantly, the provider must:

  • Ensure there are appropriate arrangements in place to effectively govern the practice and provide assurances about the quality and safety of the practice. This includes reviewing systems and processes in place to assess and monitor the quality of the service, and ensure there are sufficient systems in place to identify, assess and manage the risks relating to the health, welfare and safety of patients using the service.
  • Put in place appropriate arrangements to maintain a clean environment, and assess the risk, detect, prevent and control the spread of infections.
  • Ensure there is appropriate equipment to provide treatment to patients in a medical emergency.
  • Establish and maintain appropriate recruitment procedures and maintain records for each person employed containing the information as set out in schedule three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
  • Ensure there are appropriate opportunities for staff to update their skills and knowledge and have access to support and professional development by means of regular appraisals.

In addition the provider should:

  • Ensure that blank prescriptions are recorded in accordance with national guidance to reduce the risk of theft or misuse.
  • Make sure there are arrangements in place for those patients who wish to see a female GP.
  • Ensure there is a formal business plan in place to clearly set out the strategy for the practice and to determine how the practice operates, detailing the plans for monitoring and improving the quality of the service.
  • Initiate a discussion regarding succession planning to ensure the sustainability of the practice into the future.
  • Risk assess the impact of providing services across two sites, and in particular the arrangements for dealing with a medical emergency when there is no GP within the practice location but it remains open to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice