The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Thomas Barnwell Also known as Little Venice Medical Centre

Overall: Inadequate read more about inspection ratings

2 Crompton Street, London, W2 1ND 0844 576 9344

Provided and run by:
Dr Thomas Barnwell

Important: We are carrying out a review of quality at Dr Thomas Barnwell. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

19 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Little Venice Medical Centre on 19 September 2016. Overall the practice is rated as Inadequate.

The provider had been previously inspected on 1 December 2015 and was rated as ‘Requires Improvement’ for Safe and Effective; ‘Good’ for Caring and Responsive; and ‘Inadequate’ for Well Led. This inspection was planned to check the action taken in response to findings of the inspection undertaken on 1 December 2015 to consider whether sufficient improvements had been made. The lead GP had decided not to attend the inspection on 19 September 2016 and was therefore asked to provide comments and evidence to support the inspection via email following our visit.

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

  • The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.

  • Staff understood and fulfilled their responsibilities to raise concerns, however not all staff were clear about reporting incidents and there was no evidence of learning shared with staff to improve safety within the practice.

  • Patient outcomes were hard to identify as little or no reference was made to audits or quality improvement initiatives.
  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
  • The practice had a number of policies and procedures to govern activity, but the majority were overdue a review.
  • The practice had not proactively sought feedback from patients and the patient participation group was not active.

The areas where the provider must make improvements are:

  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements.

  • Develop effective systems and processes to ensure safe care and treatment including reporting and learning from significant events; consistent monitoring of the temperature of the medicines fridge and implementation of infection control procedures including infection control audit, correct use and disposal of sharps boxes and cleaning of clinical curtains.

  • Undertake a risk assessment for the omission of glucagon and rectal diazepam from the emergency medicines kit.

  • Ensure all staff have access to essential information and training including safeguarding and basic life support to enable them to carry out the duties they are employed to perform. Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines.

  • Ensure Patient Group Directions are signed by the appropriate persons to allow practice nurses to administer medicines in line with legislation.
  • Ensure appropriate recruitment checks are documented for all locum GPs and agency nurses working at the practice in line with regulations.
  • Implement formal governance arrangements including systems for assessing and monitoring risks and the quality of the service provision. Carry out clinical audits including re-audits to ensure improvements have been achieved.Provide staff with appropriate policies and guidance to carry out their roles in a safe and effective manner which is reflective of the requirements of the practice.
  • Seek and act on feedback from patients.

In addition the provider should:

  • Consider improving communication with patients who have a hearing impairment.

I am placing this service in special measures. Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall and after re-inspection has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group, we place it into special measures.

Services placed in special measures will be inspected again within six months. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as 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 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.

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

1 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Little Venice Medical Centre on 1 December 2015. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.

  • Patient outcomes were hard to identify as little or no reference was made to audits or quality improvement and there was no evidence that the practice was comparing its performance to others; either locally or nationally.

  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.

  • The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.

  • The practice had not proactively sought feedback from patients and there was no patient participation group.

The areas where the provider must make improvements are:

  • Ensure recruitment arrangements include all necessary employment checks for all staff.

  • Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines.

  • Carry out clinical audits including re-audits to ensure improvements have been achieved.

  • Implement formal governance arrangements including systems for assessing and monitoring risks and the quality of the service provision.

  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements.

  • Ensure all staff have access to essential training including safeguarding.

  • Ensure all actions identified as part of the fire risk assessment are completed.

  • Seek and act on feedback from patients through the development of a Patient Participation Group (PPG) and analysis of the Friends and Family Test.

In addition the provider should:

  • Advertise the translation service within the practice to inform patients this service is available to them.
  • Consider improving communication with patients who have a hearing impairment.

Where a practice is rated as inadequate for one of the five key questions or one of the six population groups the practice will be re-inspected within six months after the report is published. If, after re-inspection, the practice has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group, we will place the practice into special measures. Being placed into special measures represents a decision by CQC that a practice has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice