The Care Quality Commission
  • Doctor
  • GP practice

Dr S Garlapati and Dr A Garlapati Also known as Allen Street Clinic

Overall: Requires improvement read more about inspection ratings

Allen Street Clinic, Allen Street, Cheadle, Stoke On Trent, Staffordshire, ST10 1HJ (01538) 752674

Provided and run by:
Dr S Garlapati and Dr A Garlapati

All Inspections

25 October 2023

During an inspection looking at part of the service

We carried out an announced focused inspection) at Dr S Garlapati and Dr A Garlapati on 25 October 2023. Overall, the practice is rated as requires improvement.

Safe - inadequate

Effective – requires improvement

Caring – rating of good carried forward from previous inspection

Responsive - good

Well-led - requires improvement

Following our previous inspection on 10 July 2017, the practice was rated good overall and for all key questions. The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr S Garlapati and Dr A Garlapati on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting clinical staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.
  • Conducting staff interviews on site.

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 found that:

  • Minutes of staff meetings provided showed no evidence that safeguarding was a standing agenda item and safeguarding concerns were shared with the team.
  • Governance systems required strengthening to ensure risks were mitigated. For example, we identified concerns in relation to the actioning of safety alerts and risk assessments had not been completed to ensure the safety of the patients and staff at the practice. This included fire safety and infection control.
  • The clinical leadership team were unable to provide assurances that they had a clinical supervision process in place for non-medical prescribers and the pharmacy dispensers.
  • We identified gaps in staff training and found processes were ineffective to monitor training updates.
  • Systems within the dispensary required improvements to ensure the safety of medicines. For example: Fridge temperatures had not been recorded daily over many months.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • Patients could access care and treatment in a timely way

We found breaches of regulations. 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.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

10 July 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr P Craven and Dr N J Cunningham on 12 January 2017. The overall rating for the practice was good with requires improvement for providing safe services. The full comprehensive report on the 12 January 2017 inspection can be found by selecting the ‘all reports’ link for Dr P Craven and Dr N J Cunningham on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 10 July 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 12 January 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

  • Significant events were formally recorded, reviewed and learning shared with staff. However, a system to review significant events to identify patterns or trends was not in place.

  • Infection control issues were assessed and actioned accordingly.

  • Systems for reviewing patients prescribed a high risk medicine had been implemented.

  • A suitable medicines refrigerator was in use in the dispensary.

  • Patient Group Directions were signed and authorised.

We also saw the provider had implemented the best practice recommendations we previously made in relation to providing an effective and caring service:

  • A salaried GP’s appraisal had been completed.

  • A partition wall between two consultation rooms was in the process of being completed to ensure that private conversations were not overheard.

  • Staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

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

The provider should:

  • Implement a system to review significant events to identify patterns or trends.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

12 January 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr P Craven and Dr NJ Cunningham (Allen Street Clinic) on 12 January 2017. Overall the practice is rated as good.

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

  • Risks to patients were assessed and managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said 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 some difficulty in making an appointment with a named GP.
  • The practice was equipped to treat patients and meet their needs.
  • There was a leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour. (The Duty of Candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

The areas where the provider must make improvement are:

  • Ensure Patient Group directions are signed and authorised.
  • Ensure infection control issues are monitored and actioned accordingly.

The areas where the provider should make improvement are:

  • Ensure the INR blood levels of all patients on repeat warfarin are closely monitored before prescriptions are issued.

  • Make arrangements for the refrigerator in the dispensary to be replaced by a suitable medicines’ refrigerator.

  • Formally record and review significant events and disseminate the learning from them

  • Undertake GP appraisals.
  • Maintain dignity and privacy of all patients.
  • Consider a training update around Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
  • Review the use of the partition between clinical rooms, where consultations can be overheard.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice