Dr Jayatilaka Also known as The Leigh Surgery

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out a desk based review of Dr Jayatilaka on 27 July 2015. Our key findings regarding the safety of the practice were as follows:

• There were suitable arrangements for infection prevention and control including a suitable policy and auditing.

• Cleaning schedules and suitable cleaning equipment at the practice met the requirements in their infection control policy.
• Increased clinical time had been allocated to review, maintain and improve chronic disease management.
• Clinicians at the practice had undertaken the first cycle of clinical audits.

• Fire safety procedures had been risk assessed and fire extinguishers had been purchased.
• On-line appointments and repeat prescriptions were promoted to raise patient awareness and give flexibility when accessing services at the practice.
• The practice had appointed a replacement for the retired practice manager.

• Staff members were appraised annually and supported with access to training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Emergency processes were in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. However reviews and follow-ups for those patients on disease registers, to check patients health and care needs were being met, was lower than expected for a practice of this size.

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

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.

Immunisation rates at the practice for the standard childhood immunisations were good for the area. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly. Patients told us that children and young people were treated in an age-appropriate way and we saw evidence to confirm this. Appointments were available outside of school hours. However, the practice did not have baby nappy changing facilities.

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Care and treatment of older people at the practice did not always reflect disease management goal based needs. Emergency processes were in place and referrals were made for patients whose health deteriorated suddenly. Some older people did not have regular follow-up monitoring and reviews for chronic disease management.

Longer appointments and home visits were available for older people when needed, and this was acknowledged positively in feedback from patients. There was some adaptation to the building for disabled and less mobile patients, but the front door was heavy and there was no doorbell for patients to request assistance from the staff if they did not see them arrive at the front door.

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The services patients at the practice of working age, students and the recently retired did not reflect the needs of this group. Although the practice offered extended opening hours for appointments on one evening a week, they had not monitored patient uptake to check this was sufficient to meet their needs. Patients could book appointments and order repeat prescriptions online although patients we spoke with were unaware this service was available. Health promotion advice and literature was available, but there were no health promotional clinics.

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Patients experiencing poor mental health had received an annual physical health check, but we did not find evidence that these had been followed up regularly. The practice worked with a multi-disciplinary team for patients experiencing poor mental health and those with dementia.

We saw that the practice had information displays within the waiting area for patients experiencing poor mental health about how to access various support groups and voluntary organisations for example MIND. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Most staff had received training on how to care for patients with mental health needs.

Updated 19 March 2015

The provider was rated as good for effective, caring, responsive and well-led this includes for this population group. The provider was rated as requires improvement for safe. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice held a register of patients living in vulnerable circumstances including homeless patients, travellers and those with a learning disability. It had carried out annual health checks for patients with a learning disability, but we did not find evidence that these had been followed up regularly.

The practice worked with a multi-disciplinary team in the case management of vulnerable patients. It had information displays within the waiting area that told 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, and told us they referred safeguarding issues to the nominated safeguarding lead to be dealt with at the practice.