• Doctor
  • GP practice

Dr Yousef Rashid Also known as Shifa Medical Practice

Overall: Good read more about inspection ratings

Gascoigne Road, Barking, Essex, IG11 7RS 0844 477 2544

Provided and run by:
Dr Yousef Rashid

All Inspections

During an assessment under our new approach

Date of assessment 27 February to 5 March 2024. Dr Yousef Rashid is registered with CQC to deliver primary care services at Shifa Medical Centre in Barking in East London. The practice has around 2400 registered patients. The practice is located in an area with relatively high levels of income deprivation and unemployment. The practice population is ethnically diverse. The practice is led by an individual GP who works full-time at the practice. The practice also employs a practice nurse, a practice manager and reception staff. The practice is open between 8am and 6.30pm Monday to Friday. This assessment was carried out in response to CQC identifying potential risk at the practice. The practice was previously rated as requires improvement and this assessment focused on the concerns identified at the previous inspection. We assessed a total of 17 quality statements across the safe, effective, responsive, and well-led key questions. The scores for these areas have been combined with scores based on the key question ratings from the last inspection. The practice demonstrated it had improved its systems to monitor prescribing and implement safety alerts. There were effective infection prevention and control procedures in place and systems to learn from safety incidents and complaints. The practice had clear governance systems with effective managerial and clinical oversight.

From 9 February to 1 March 2022

During a routine inspection

Following our previous inspection, on the 10 November 2020, the practice was rated Requires Improvement overall. The key questions were rated as inadequate for providing an effective service, requires improvement for providing a safe and well-led service and good for providing a caring and responsive service. At the inspection we issued a breach of Regulation 17 (Good Governance) and 12 (Safe Care and Treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The practice, also remained in special measures because it had not made sufficient improvements.

The full report of the previous inspection can be found by selecting all reports linked for Dr Yousef Rashid on our website www.cqc.org.uk.

Why we carried out this inspection.

We carried out an announced inspection at Dr Yousef Rashid practice, from the 9 February to 1 March 2022, to review the improvements made by the service in response to the breaches of regulation. The key questions we inspected were safe, effective and well-led.

During this inspection we also considered the management of access to appointments.

Overall, the practice is rated as Requires Improvement.

Safe - Good.

Effective - Requires Improvement.

Well-led – Requires Improvement.

How we carried out the inspection.

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

Our findings

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 Requires Improvement overall

We found that:

  • The practice had taken steps to mitigate risks to provide a safe service.
  • The provider had increased the number of hours worked by the practice nurse and was in the process of developing a GP partnership at the practice. However, these changes had either not yet been implemented or fully embedded and therefore not resulted in improvements.
  • The provider had made improvements in the uptake of childhood immunisations.
  • However, further work was required to understand the lower cancer indicators against the local clinical commissioning group and England average data.
  • A review of patient records found that patients had received effective care and treatment. However, in some cases, the record of the consultation in the patient notes would have benefitted from further explanation.
  • The provider had responded to concerns regarding significant events and MHRA safety alerts.
  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
  • Patients could access care and treatment in a timely way.

We found one breach of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Whilst we found no other breaches of regulations, the provider should:

  • Include the responses to prevent the spread of COVID 19 in the infection prevention and control annual risk assessment.
  • Implement a formal recovery plans in place to identify, manage activity and delays to treatment caused by the pandemic.
  • Implement a formal protocol to assist reception staff to prioritise patient appointments.
  • Improve the communication by staff of the opportunity for patients to see a female GP.
  • Complete and embed the changes made at the previous inspection, such as the increased hours of the practice nurse and succession planning.
  • Record the reasons for the vaccine fridge temperatures, when it is out of range of the national guidelines.

Due to the improvements made we have removed this practice from special measures.

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

10 November 2020

During a routine inspection

We carried out an announced comprehensive inspection at Dr Yousef Rashid also known as Shifa Medical Practice on the 30th January 2019. At that time we rated the practice as inadequate overall and as a result of the rating the practice was placed in special measures.

We conducted a six month follow-up special measure inspection of the practice on the 23rd September 2019 and subsequently rated the practice as requires improvement for the key questions of safe and well-led, good for the key question of caring and responsive and inadequate for the key question of effective. This led to an overall rating of requires improvement. However, as key question effective remained rated as inadequate, the practice remained in special measures to ensure that people who use the service had the reassurance that the care they get should improve.

Breaches of regulatory requirements were found, and requirement and warning notices were issued in relation to patient safety, good governance and staffing issues.

The reports of all the previous inspections can be found by selecting the ‘all reports’ link for Dr Yousef Rashid on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection which we undertook on 10 November 2020 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 23 September 2019.

This report covers our findings in relation to those requirements. We found that there had been continued improvement since our last comprehensive inspection in September 2019. These improvements included embedded system processes, regular policies and procedures reviews and new staff recruitment. However, there were still areas where the practice need to improve further including increased uptake for childhood immunisations and cervical screening.

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
  • Information from the provider, patients and the public.

This provider continues to be rated as requires improvement

We rated the practice as good for providing caring and responsive services because:

• The provider provided care in a way that treated patients with dignity and respect.

• The provider supported carers registered at the practice through providing seasonal vaccines and signposting them to appropriate organisations.

• GP patient survey results were comparable to local and national averages.

We rated this provider as requires improvement for safe and well-led services because:-

  • The provider had increased staffing through the recruitment of a new permanent part-time practice nurse and part-time clinical pharmacist.
  • The practice had a vision but the vision was not supported by a credible strategy.
  • Governance arrangements had improved evidenced through reviewed policies and procedures.
  • The practice now had embedded recall systems in place for cytology and childhood immunisations to ensure that patients were followed up when they did not attend the practice when invited to.
  • The management of safety alerts received, disseminated and who was responsible for actioning within the practice was not clear.

We rated this provider as inadequate for effective services because:-

  • Childhood immunisation rates were below the national target in three out of the four indicators.
  • The nursing provision at provider continued not sufficient to address the need of the population groups.
  • Uptake rates for the cervical screening programme were below the national target.
  • The practice rate for two-week cancer referrals were below the national target.

The areas where the provider must make improvements are:-

  • Ensure care and treatment is provide in a safe way to patients.
  • Ensure effective systems and processes to ensure good governance in accordance.

The areas where the provider should make improvements are:-

  • To identify whether the premises landlord had conducted a recent security risk assessment.
  • To confirm with the premises landlord that actions required as a result of the last health and safety audit had been completed.
  • Evidence clearly learning achieved by practice staff following complaints.

This service will remain in special measures. Services 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.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

23 September 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Yousef Rashid also known as Shifa Medical Practice on 30 January 2019 and rated the practice as requires improvement for the key question of responsive, good for the key question of caring and inadequate for the key questions of safe, effective and well-led. This led to an overall rating of inadequate and the service was placed in special measures.

Breaches of regulatory requirements were found, and requirement and warning notices were issued in relation to patient safety, good governance and staffing issues.

The reports of all the previous inspections can be found by selecting the ‘all reports’ link for Dr Yousef Rashid on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection which we undertook on 23 September 2019 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 30 January 2019.

This report covers our findings in relation to those requirements. We found that there had been improvement since our last comprehensive inspection in January 2019. These improvements included an increase in staffing, better awareness, understanding and compliance in relation to issues that could affect patient safety and, finally an improvement in the way the provider was using governance to deliver efficient services at this location.

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 and the public.

We have now rated this provider as requires improvement overall.

We rated the practice as good for providing caring and responsive services because:

  • The provider provided care in a way that treated patients with dignity and respect.
  • The provider supported carers registered at the practice through providing seasonal vaccines and signposting them to appropriate organisations.
  • GP patient survey results were comparable to local and national averages.

We rated this provider as requires improvement for safe and well-led services because:-

  • The provider had improved some record keeping but not sufficiently in relation to the monitoring of patients who had been prescribed high-risk medication.
  • Childhood immunisation rates were below the national target in three out of the four indicators.
  • The provider had increased staffing through the recruitment of new administration staff and a part-time practice manager, however it was too early to fully assess any positive impact on services provided.
  • The nursing provision at provider was not sufficient to address the need of the population groups.
  • The practice had a vision but the vision was not supported by a credible strategy.
  • Governance arrangements had improved evidence through updated policies and procedures, however it was too early to fully assess any positive impact on services provided.

We rated this provider as inadequate for effective services because:-

  • Uptake rates for the cervical screening programme were below the national target.
  • Childhood immunisation rates were below the national target in three out of the four indicators.
  • The practice did not have embedded recall systems in place for cytology and childhood immunisations to ensure that patients were followed up when they did not attend the practice when invited to.
  • The nursing provision at provider was not sufficient to address the needs of some of the population groups.

These areas affected all population groups, so we rated all population groups as requires improvement.

The areas where the provider must make improvements are:-

  • Ensure care and treatment is provide in a safe way to patients.
  • Ensure effective systems and processes to ensure good governance in accordance.

The areas where the provider should make improvements are:-

  • To provide training to administrative staff regarding the signs of sepsis.
  • To identify whether the premises landlord has conducted a recent security risk assessment.
  • To obtain and retain multi-disciplinary team meeting minutes.

This service will remain in special measures. Services 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.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

14 May 2019

During a routine inspection

Dr Yousef Rashid is a provider registered with CQC.

We carried out an inspection of the provider on 14 May 2019 to follow up concerns raised at our inspection on 30 January 2019.

At the inspection in January 2019 we found that:

  • Patients on high-risk medication were not having appropriate monitoring completed in line with guidelines for safe prescribing and we found that the system for reviewing uncollected prescriptions was not effective.
  • Systems for staff training, appraisal and recruitment were not effective.
  • Emergency medicines were not all stored correctly, in date and the practice did not have all recommended emergency medicines or a risk assessment which explained their absence.
  • Equipment had not been PAT tested or calibrated.
  • Patient records were not always updated with information from secondary care services after discharge.
  • The practice had not effectively monitored and made significant improvements in diabetes, HbA1c performance.
  • The practice did not maintain an at-risk register for vulnerable adults and children. In addition, there was no process in place to identify carers.
  • Governance systems were lacking. For example; practice policies had not been reviewed since 2016, verbal complaints remained unrecorded, staff were not aware of a clear governance structure and the practice did not hold regular practice meetings that were minuted.
  • The practice did not have a programme in place to monitor quality improvements and subsequently make improvements.

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.

At this inspection we found that:

  • Systems for monitoring patients prescribed high risk medicines continued to be not safe or effective.
  • Emergency medicines were checked and in date and the practice’s box of uncollected prescriptions was regularly reviewed.
  • Hospital discharges reviewed showed that the practice was taking appropriate action in response to requests from other health services.
  • Data for 2019/20 indicated that performance against targets for diabetes had improved year to date but that the proportion of the patient list identified as having diabetes had reduced considerably.
  • A programme of clinical audit had been considered but not yet initiated.
  • Governance arrangements had improved as there was a up to date policy framework in place covering most areas of operation; including systems to record verbal complaints yet some newly appointed staff were unclear about leadership roles. Regular practice meeting had also been initiated.
  • Recruitment, training and appraisal processes had improved and the practice were in the process of setting up systems to oversee staff training.
  • Risks associated with the premises had been assessed and had either been addressed or were in the process of being addressed.
  • The practice had identified those with caring responsibilities and adults who were vulnerable. However, the practice had not identified any at-risk children on their patient list.

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.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review the practice’s patient list to ensure that those with diabetes and at-risk children are being identified and supported.
  • Clarify leadership roles for newly appointed staff working at the practice.
  • Continue with work to monitor staff training and upgrade the premises in light of infection control audits.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Please refer to the detailed report and the evidence tables for further information.

30 January 2019

During a routine inspection

We carried out an announced comprehensive inspection at Dr Yousef Rashid also known as Shifa Medical Practice on 29 December 2017 and rated the practice as requires improvement for the safe, effective and well-led key questions. This led to an overall rating of requires improvement. Breaches of legal requirements were found and requirement notices were issued in relation to patient safety and governance.

The reports of all the previous inspections can be found by selecting the ‘all reports’ link for Dr Yousef Rashid on our website at www.cqc.org.uk.

This inspection was an announced focused inspection which we undertook on 30 January 2019 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 12 December 2017. This report covers our findings in relation to those requirements. We found that there had not been an improvement and the practice is now rated as inadequate overall and has been placed in special measures for a period of six months.

We have rated this practice as inadequate overall.

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 and the public.

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

  • The practice had still failed to carry out Disclosure and Barring Service (DBS) checks on staff who acted as chaperones.
  • Checks of medicines and related equipment stored in the practice were not carried out consistently to ensure that they remained safe and effective. We found some expired medical emergency equipment.
  • The practice’s performance remained below local and national averages for management of diabetes.
  • Verbal complaints were not formally recorded and we did not see evidence that they had been discussed with staff. The practice did not carry out formal, minuted staff meetings.
  • Practice policies had not been updated annually.
  • Staff did not have all the required training and recruitment files did not contain the appropriate recruitment checks.
  • There was no evidence that the practice nurse had medical indemnity insurance.
  • Patient’s medication reviews were not formalised and did not contain the required information.
  • There was a lack of governance arrangements to ensure that quality assurance processes were in place which led to improvements in patient outcomes.

The areas where the provider must make improvements are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure that persons employed at the practice have received appropriate training.

(Please see the specific details on action required at the end of this report). Note: Warning notices were issued to the provider following the inspection undertaken on 30 January 2019. This was to ensure that the provider was aware of our concerns and that action was taken quickly to address these concerns and mitigate risks to patients.

Requirement notices were issued for the additional concerns which related to breaches identified. The level of risk stemming from these concerns was not deemed to be sufficient to require additional enforcement action.

The areas where the provider should make improvements are:

  • Take steps to improve the uptake of childhood immunisations rates.
  • Develop a process aimed at identifying patients with caring responsibilities to be able to provide appropriate support and signposting.
  • Review staffing levels at the practice to ensure that there is sufficient capacity to complete all necessary tasks.
  • Consider developing a structure for minuted staff meetings to take place, to facilitate lessons learned and improvements to be made.
  • Take steps to develop and maintain care plans for patients with learning disabilities.

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

6 November 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 at Dr Yousef Rashid also known as Shifa Medical Practice on 5 December 2016 and rated the practice as requires improvement for safe, effective and well-led key questions. This led to an overall rating of requires improvement. Breaches of legal requirements were found and requirement notices were issued in relation to patient safety and governance. The full comprehensive report can be found by selecting the http://www.cqc.org.uk/provider/1-199797857 link for Shifa Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection which we undertook on 6 November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 December 2016. This report covers our findings in relation to those requirements. The overall rating from this visit remains requires improvement. Our key findings across all the areas we inspected were as follows:

  • The practice had few policies to govern activities and those we reviewed were not fit for purpose as they were outdated and/or contained incorrect information.

  • Verbal complaints were not formally recorded and we did not see evidence they were discussed during staff meetings.

  • Staff who acted as chaperones were not trained for the role and had not received a Disclosure and Barring Service (DBS) check.

  • We found the practice was still failing to carry out appropriate recruitment checks prior to employment.

  • This practice’s performance was below local and national averages for management of diabetes.

  • At the inspection of 5 December 2016, the practice had identified two patients as carers. At this inspection, 11 patients were identified as carers which was less than one percent (1%) of the practice list.

Importantly, the provider must:

  • Ensure care and treatment is provided in a safe way to patients.

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Update business continuity plan to include contact details for all members of staff so that they can be contacted should an emergency arise.

  • Take steps to improve the practice’s performance in the management of diabetes.

  • Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

5.12.2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shifa Medical Practice on 5 December 2016. Overall the practice is rated as requires improvement.

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

  • Staff understood their responsibility for reporting and recording incidents.

  • We saw examples of incidents, which were reviewed identifying the lessons learned.

  • The practice carried out regular medicines audits, with the support of the local CCG pharmacy team, to ensure prescribing was in line with best practice guidelines for safe prescribing.

  • Data from the Quality and Outcomes Framework (QOF) showed most patient outcomes were at or above average comparable to the national average.

  • Members of staff were courteous and very helpful to patients and treated them with dignity and respect. We saw staff treated patients with kindness and consideration.

  • All relevant new clinical guidelines were forwarded to the practice nurse and the GP made sure new guidelines were put into practice.

  • The practice analysed their A&E attendances and hospital admissions to identify where they could be reduced.

  • Results from the national GP patient survey showed patients felt they were treated with compassion, dignity and respect. The practice was above average for its satisfaction scores on consultations with the GP and nurse

  • Access to appointments was good. Patients said they were usually offered an appointment within a couple of days and could book on line.

  • The lead GP demonstrated they had the experience, capacity and capability to run the practice and ensure good quality care.

The areas where the provider must make improvements are:

  • Ensure all staff carrying out chaperoning duties are trained for the role.

  • Ensure all staff have a DBS check or are risk assessed and references are obtained for all new staff.

  • Patient Group Directions are implemented for all procedures carried out by the practice nurse.

  • Ensure all policies and procedures which govern activity within the practice are up to date.

  • Develop a clear governance framework and structure which clarifies the roles and responsibilities of all staff.

In addition the provider should:

  • Improve the management of long term conditions including CHD, COPD and diabetes.

  • Secure blank prescription forms kept behind the main reception desk.

  • Provide all staff with appraisals to provide feedback on progress and development.

  • Review the number of carers being supported by the practice because less than 1% of the practice’s list had been identified as carers.

  • Keep written records of verbal complaints in addition to complaints received in writin

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice