Background to this inspection
Updated
12 June 2018
Dr Muthulingam Sathananthan, also known as Manor House Practice, is a single location practice which provides NHS primary care services to approximately 2,000 patients living in the Feltham area through a General Medical Services (GMS) contract. The practice occupies Feltham Centre for Health which it shares with three other practices and is part of Hounslow Clinical Commissioning Group (CCG). There are above average numbers of patients in the age ranges 0-15 and 30-49. The practice population is predominantly white British and Asian/Asian British, followed by mixed multiple ethnic groups including Indian, Pakistani and other Asian, African and Caribbean and Europeans.
The practice staff comprises one male GP (providing 10 clinical sessions per week) supported by a regular locum GP and part-time practice nurse. The clinical team is supported by a part-time acting practice manager, three part-time receptionists and two part-time locum receptionists.
The practice is open between 8am and 8pm Monday; 8am to 6pm Tuesday, Thursday and Friday; and 8am to 1pm Wednesday. Appointments are from 9am to 11am daily and 4pm to 5.30pm daily except Wednesday. Extended hours appointments are offered between 6.30pm and 8pm on Monday. In addition to pre-bookable appointments that can be booked in advance, urgent appointments were also available for patients that needed them.
When the surgery is closed, out-of-hours services are accessed through the local out of hours service or NHS 111.
The practice is registered with the Care Quality Commission to carry on the following regulated activities:
Diagnostic and screening procedures
Maternity and midwifery services
Surgical procedures
Treatment of disease, disorder or injury
Updated
12 June 2018
This practice is rated as Inadequate overall. (Previous inspection 17 January 2017 – Requires improvement)
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Inadequate
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Inadequate
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Inadequate
People with long-term conditions –Inadequate
Families, children and young people – Inadequate
Working age people (including those recently retired and students – Inadequate
People whose circumstances may make them vulnerable – Inadequate
People experiencing poor mental health (including people with dementia) - Inadequate
We carried out an announced comprehensive inspection at Dr Muthulingam Sathananthan on 8 February 2018. The inspection was carried out to follow up on breaches of regulations identified at our inspection of 17 January 2017 and confirm that the practice was now meeting legal requirements.
At this inspection we found:
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The practice had made improvements in the provision of safe services since our previous inspection in January 2017. However, some of our concerns had not been addressed sufficiently in relation to staff training; the system for managing emergency medicines; medicines management as a whole; and staff recruitment.
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The practice ensured that care and treatment was delivered according to evidence-based guidelines.
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Despite some improvement in QOF performance overall and in areas found to be below average at our previous inspection, performance remained below average for several clinical indicators at our latest inspection.
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There was no formal ongoing programme of quality improvement, including clinical audit. The practice carried out ad hoc clinical audit but no audits currently in train were completed full audit cycles to show improved patient outcomes.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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Patients who were carers were identified and offered appropriate support.
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The practice organised and delivered services to meet patients’ needs. It took account of patient needs and preferences.
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Patients found the appointment system easy to use and the majority reported that they were able to access care when they needed it.
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The principal GP lacked sufficient management support and this had impacted on his capacity to lead effectively and consistently deliver high-quality, sustainable care.
The areas where the provider must make improvements as they are in breach of regulations are:
I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice