Archived: Mrs Saeeda Parwaiz Also known as Ratby Surgery

Updated 17 September 2015

Ratby Surgery, is located in Ratby a commuter village and civil parish in the Hinckley and Bosworth district of Leicestershire, England. It has a population of about 4,000. The practice provides GP services under a (GMS) General Medical Services contract to 2800 patients. The practice was established in 1986 by Dr Parwaiz.

The patient population has a relatively low deprivation score of 11.5 compared with a national average of 23.6, although within the practice population there was some evidence of deprivation. Both male and female life expectancy are slightly above the national average. The age distribution of the practice has a higher percentage of people between the ages of 40 and 49 against that of the national profile.

The practice has a single partner GP, one practice nurse, a practice manager and a strategy manager (managing partner) alongside three reception staff and a cleaner who is directly employed by the practice. Locum GPs are used to support the partner GP. The practice had successfully recruited a new partner to join the practice in the coming months.

The practice is located over two floors, though all areas accessed by patients were located on the ground floor.

The surgery is open from 8.00 am until 6.00 pm Monday to Friday, with GP consultations available from 9 am to 11am and 3.00 pm until 5.30 pm. On Thursday the surgery closed at 1.00pm and GP appointments were available from 9.00am to 1.00pm. The practice provides evening appointments by prior arrangement on a Monday evening until 8pm.

The practice lies within the NHS West Leicestershire Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided by Leicester, Leicestershire and Rutland out-of -hours service.

The practice was previously inspected by the Care Quality Commission on 6 February 2014. This was using our previous methodology and consequently was not rated. At that inspection it was found to be compliant in all areas inspected.

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ratby Surgery on 12 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, well-led, effective, caring and responsive services. It was also good for providing services for older people; patients with long term conditions; families children and young people; working age people and those recently retired; people experiencing poor mental health and people whose circumstances may make them vulnerable. We found the practice to be requiring improvement in safe.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• 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 found it easy to make an appointment and that 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.
• 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.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Information about services and how to complain was available and easy to understand.

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

Importantly the provider must;

• Ensure that the recruitment policy is followed in all and that appropriate recruitment checks For example, proof of identification, references, qualifications, registration with the appropriate professional body and the appropriate checks through the Disclosure and Barring Service (DBS).

• Ensure that all staff receive an annual appraisal and that it is recorded.
• Ensure that a policy for the management, testing and investigation of legionella is implemented or that a risk assessment has taken place.

Importantly the provider should;

• All procedures and policies to be reviewed to ensure their relevance and current best practice.
• Ensure that clinical audits include a second cycle to complete the process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 September 2015

The practice is rated as good for the care of people with long-term conditions.

Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice also linked with the CCG for specialist nurses to work in practice to assist in the management of patients, for example, diabetes and COPD. Longer appointments and home visits were available when needed. As the practice was single handed, all the patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 September 2015

The practice is rated as requires improvement for the care of families, children and young people.

There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances where brought to the attention of the GP. Immunisation rates were below average for some of the standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 17 September 2015

The practice is rated as good for the care of older people.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 17 September 2015

The practice is rated as good for the care of working-age people (including those recently retired and students).

The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice website signposted patients to other healthcare services as well as a full range of health promotion and screening that reflects the needs for this age group. For example the practice had exceeded the target figure of 80% of women eligible for a cervical smear test.

Updated 17 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

100% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. Due to the workload pressures at the practice and being a single handed GP the practice recognised that they can improve on the diagnosis and screening rates for dementia and this will be something that will be looked at with the new partner starting.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND. Staff had received training on how to care for people with mental health needs and dementia.

Updated 17 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable including homeless people, travellers and those with a learning disability.

The practice had carried out annual health checks for people with a learning disability and all of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

The practice had 113 travellers on its practice list as permanent patients, which is four percent of the list size. The practice worked well with and had good liaison with a nurse employed by the clinical commissioning group who dealt specifically with patients in this group.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.