22 August 2017
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Maria Coutinho on 13 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on 13 July 2016 can be found by selecting the ‘all reports’ link for Dr Maria Coutinho on our website at www.cqc.org.uk.
Since the 13 July 2016 inspection the registered provider has moved location from 213 Burrage Road Plumstead London SE18 7JZ to 2 Garland Road Plumstead London SE18 2AE.
This inspection was an announced comprehensive inspection on 22 August 2017. Overall the practice remains rated as requires improvement.
Our key findings were as follows:
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
- All practice policies and procedures had been updated.
- The practice had purchased a defibrillator, and all staff had been trained on how to use it.
- The provider was aware of and complied with the requirements of the Duty of Candour. Examples we reviewed showed the practice complied with these requirements.
- No full cycle audits had been conducted.
- Immunisation rates were slightly below average for all standard childhood immunisations.
- Patients did not have care plans in place.
- Fridge temperatures were monitored, however there was only an internal thermometer being used and it was not calibrated frequently. This is not in accordance with Public Health England guidance.
- Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
- Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
- Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
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There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
However, there were also areas of practice where the provider needs to make improvements.
Importantly, the provider must:
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Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
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Do all that is reasonably practicable to mitigate any such risks.
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Ensure quality improvement programmes are conducted to improve patients’ outcome.
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Ensure there is a system in place to monitor safety alerts.
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Ensure that patients who require care plans have them.
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Ensure staff are up to date with training.
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Ensure systems are in place to review clinical staff registration details and medical insurance annually.
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Ensure registration regulated activities are updated.
In addition the provider should:
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Review temperature monitoring on the medicine fridge to make sure it is in line with current guidance.
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Continue to review antibiotic prescribing.
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Continue to try and obtain emergency medicine Hydrocortisone.
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Update their business continuity plan.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice