Archived: Dr Lalta Sachdeva

Updated 13 November 2017

Dr Lalta Sachdeva (also known as Abbey Court Medical Centre) delivers services from purpose built premises in Tunbridge Wells, Kent. There are 4,000 patients on the practice list. The practice is similar across the board to the national averages for each population group. For example, 38% are aged under 18 years compared to the CCG average of 40% and the national average of 38%. Scores were similar for patients aged 65, 75 and 85 years and over. The practice is in one of the least deprived areas of Kent.

The practice holds a General Medical Service contract and is led by two GP partners (female and male). The GP partners are supported by a locum GP (female), a practice nurse (female) and a healthcare assistant (female), a practice manager and a team of administration and reception staff. A range of services and clinics are offered by the practice including asthma and diabetes.

The practice is open from 8am to 6.30pm. Morning appointments are from 8.30am to 11.00am and afternoon appointments are from 3.30pm to 6pm. There is an early morning clinic every Tuesday from 7am to 8.30am, a lunch time clinic every Wednesday from 1.30pm to 4pm and an early evening clinic every Wednesday from 6pm to 7.30pm.

An out of hour’s service is provided by Integrated Care 24, outside of the practices open hours. There is information available to patients on how to access this at the practice, in the practice information leaflet and on the website.

Services are delivered from:

Dr Lalta Sachdeva, Abbey Court Medical Centre, 3rd Floor Abbey Court, 7-15 St Johns Road, Tunbridge Wells, Kent, TN4 9TF

Updated 13 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Lalta Sachdeva (also known as Abbey Court Medical Centre) on 9 February 2017. The overall rating for the practice was requires improvement. The practice was rated as requires improvement for providing effective, caring and well-led services and rated as good for providing safe and responsive services. The full comprehensive report on the February 2017 inspection can be found by selecting the ‘all reports’ link for Dr Lalta Sachdeva on our website at www.cqc.org.uk.

This inspection was an announced focused inspection conducted on 4 October 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 9 February 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had improved its systems and processes in order to help ensure care plans were comprehensive in detail.

• Data showed patient outcomes were below the local and national average in some areas of care, Quality and Outcomes Framework

• Governance arrangements had been improved. These helped to ensure there was an effective system for routinely checking the indemnity insurance of all clinical staff, thatcare plans were being routinely reviewed, monitored and updated (where appropriate) and test results were being routinely actionedAdditionally, national GP patient survey results were also being monitored and reviewed.

The practice had also taken appropriate action to address areas from our previous inspection where they should make improvements:

• The practice had taken appropriate measures to help ensure they identified patients who are also carers so that they are offered appropriate support. % of the practice list).

However, there were areas where the provider should make improvement:

• Continue to ensure care plans are updated, in accordance with their action plan to address areas where data is unknown. For example, care plans which had next of kin contact details recorded as ‘unknown’.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators were lower than the national average, with 68% of patients with diabetes, on the register, in whom the last IFCCHbA1c (a blood test to check blood sugar levels) was 64 mmol/mol or less in the preceding 12 months (local average 78% and national average 79%). However, this was a 15% increase on the previous year.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Care plans were now comprehensive in detail and contained up to date information.

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• There were systems 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. Immunisation rates were below average for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the local average of 83% and the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• There was an early morning clinic every Tuesday from 7am to 8.30am, a lunchtime clinic every Wednesday from 1.30pm to 4pm and an early evening clinic every Wednesday from 6pm to 7.30pm in order to support commuters with accessing appointments.

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Performance for dementia related indicators were similar to the local and national averages. Eighty eight percent of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local and national average of 84%.

• Performance for mental health related indicators were similar to the local and national averages. For example, 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (local average 92% and national average 89%).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 13 November 2017

The provider had resolved the concerns for the provision of effective, caring and well-led care identified at our inspection on 9 February 2017 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.