Dr C Dahs & Dr I P Humberstone - Care Quality Commission

Background to this inspection

Updated 17 February 2017

Dr Dahs & Dr I P Humberstone provides primary medical services in Upminster, Essex to approximately 11,300 patients and is one of fifty-three member practices in the NHS Havering Clinical Commissioning Group (CCG).

The practice team comprises one full-time female partner and one full-time male GP partner along with three full-time salaried GPs (one female and two male) working between them a whole time equivalent (WTE) of 5 GPs (40 sessions per week). The nursing team consists of three part-time female nurse practitioners, one full-time female practice nurse and one part-time female practice nurse There are four administrative and clerical staff and one full-time practice manager.

Dr Dahs & Dr I P Humberstone are registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures; family planning; surgical procedures; maternity and midwifery services; treatment of disease, disorder or injury. They currently have two registered locations, Little Gaynes Surgery and Cranham Village Surgery. Both locations are purpose built GP surgery buildings and clinical and administrative staff divide their time between the two surgeries. There are five part-time reception staff at the Little Gaynes Surgery.

Consulting rooms at Little Gaynes Surgery are all on the ground floor. There are administrative offices and staff facilities on the first floor.

The practice is open between 8.00am and 6.30pm Monday to Friday. GP Appointments are from 8am to 12.30pm and 2.30pm to 6pm, nurse practitioner and nurse appointments are from 8am until 6pm daily. Between 6.30pm and 8.00am and at weekends patients are directed to the out of hours provider for Havering CCG.

The practice population is in the least deprived decile in England with less than the CCG and national average representation of income deprived children and older people. The practice population has a greater than national average percentage of all age groups over fifty years of age, with 26% of the practice population aged over 65 (national average 17%). There is below average income deprivation affecting children of 7% compared to the national average of 23%.

The practice has surveyed the ethnicity of the practice population and has determined that 97% of patients identified as having white ethnicity, and 3% as having Asian ethnicity.

The practice operates under a Personal Medical Services (PMS) contract (a contract between NHS England and general practices for delivering personal medical services. This contract allows the flexibility to offer local services within the contract) and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract). The enhanced services it provides are: childhood vaccination and immunisation scheme; facilitating timely diagnosis and support for people with dementia; influenza and pneumococcal immunisations; minor surgery; remote care monitoring; and risk profiling and case management.

Overall inspection

Good

Updated 17 February 2017

Letter from the Chief Inspector of General Practice

This is a desk top review of evidence supplied by Dr C Dahs and Dr I P Humberstone, for areas within the key question Safe. This review was completed on 20 December 2016.

Upon review of the documentation provided by the practice, we found the practice to be good in providing safe services. Overall, the practice is rated as good.

The practice was previously inspected on 17 February 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA). At that inspection, the practice was rated good overall. However, within the key question safe several areas were identified as requires improvement , as the practice was not meeting the legislation to meet Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safe Care and Treatment.

At the inspection in February 2016 we found that the registered person did not assess and mitigate against risks as they had not risk assessed the need for Disclosure and Barring Service (DBS) checks for chaperones. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

Other areas identified where the practice was advised they should make improvements included:

Reviewing or risk assessing arrangements for medical emergencies to ensure that equipment and medicines are in place.
Reinstating Patient Participation Group (PPG) meetings, in order to identify and act on patients’ feedback and suggestions about the service.
Conducting patient surveys as a means of obtaining patient feedback.
Preparing a business continuity plan to be ready for any interruptions to service.
Conducting regular fire evacuation drills in line with the fire risk assessment.

The practice supplied CQC with evidence of the action they would take after the inspection in February 2016. For this desk top review they provided a range of documentation which demonstrated they are now meeting the requirements of Regulation 12 Safe Care and Treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The practice also demonstrated improvement in the other areas identified in the report from February 2016 which did not affect ratings. These improvements have been documented in the well-led section, showing how the practice has demonstrated continuous improvement since the inspection in February 2016.

The area where the practice should continue to make improvements are:

Formalise the processes in place to protect patients by completing a written risk assessment for staff who act as chaperones who are not DBS checked, including updating the chaperone policy to reflect amended procedures.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice