Background to this inspection
Updated
24 June 2019
Dr P Kumar & Partners (also known as Chessington Park Surgery) is located in Chessington, a suburb in South West London bordering Surrey, and is one of 21 practices in Kingston Clinical Commissioning Group (CCG). The practice had approximately 7300 patients at the time of our inspection.
Chessington Park Surgery is located within purpose built premises, Merritt Medical Centre, which it shares with another GP practice and a pharmacy. A large carpark is available at the practice, and there is space to park in the surrounding streets. The reception desk, waiting area, consultation rooms and administrative offices are situated on the ground floor. Further administrative space and meeting rooms are on the first floor.
The practice population is in the second least deprived decile in England. The proportion of children registered at the practice who live in income deprived households is 15%, which is higher than the CCG average of 12%; and for older people the practice value is 11%, which is lower than the CCG average of 13%. The age profile of patients registered at the practice is broadly the same as local and national averages. Of patients registered with the practice, the largest group by ethnicity are white (85%), followed by Asian (8.5%), mixed (3%), black (2%) and other non-white ethnic groups (1.5%).
The practice’s clinical staffing team are made up of two full-time male GP partners, three part-time salaried GPs, a nurse practitioner, two practice nurses, and a healthcare assistant. The administrative team consist of a practice manager, an assistant practice manager, an office manager, and a team of reception and administrative staff. In total 33 GP sessions are available per week, plus seven nurse practitioner sessions.
The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract).
The practice is open from 8.00am to 1.00pm, then 2.00pm to 6.30pm on weekdays. Extended hours surgeries are offered between 6.30pm and 8pm on Wednesdays and Thursdays, and every other Saturday morning from 9am to 11:30am.
Updated
24 June 2019
This practice is rated as Good overall. (Previous inspection May 2018 – Requires improvement).
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection of Dr P Kumar & Partners (also known as Chessington Park Surgery) on 22 May 2018. The practice was rated as requires improvement overall. A breach of legal requirements was found relating to the Safe, Effective and Well-led domains. After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulations 12 (Safe care and treatment), 17 (Good governance) and 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
During the comprehensive inspection we found that the practice had failed to store and monitor prescription stationery in line with guidance, ensure that care plans for patients with learning disabilities and dementia were comprehensively recorded, ensure that the necessary monitoring had taken place prior to issuing prescriptions for high risk medicines, put processes in place to ensure that medicines and safety alerts were appropriately acted on, put in place arrangements to monitor and support non-medical prescribers, undertake appraisals for nursing staff, and put in place quality improvement processes. We also identified areas where improvements should be made, which included putting in place arrangements to monitor the process for seeking patient consent and putting in place resources to assist staff in communicating with patients with learning disabilities.
We undertook this announced focussed inspection on 14 May 2019 to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr P Kumar & Partners on our website at .
Following the focussed inspection, we found the practice to be good for providing safe, effective and well-led services.
At this inspection we found:
- The practice had processes in place to keep prescription stationery secure and monitor its use. Processes were in place to ensure that safety and medicines alerts were shared with the appropriate members of the team and that any necessary action was taken.
- The practice had introduced processes to review of the effectiveness and appropriateness of the care it provided; for example, they had introduced regular audits of the prescribing of high risk medicines, controlled drugs and seeking patient consent. They had carried-out an audit of the nurse practitioner’s antibiotic prescribing, but this did not extend to the antibiotic prescribing by GPs.
- Care plans were in place for patients who needed them, and these contained an appropriate level of detail. Resources were available to help staff to assess the level of pain being experienced by patients with learning disabilities.
- Appraisals had been completed for all staff and processes had been put in place to support the nurse practitioner in their role as a prescriber.
The areas where the provider should make improvements are:
- Consider expanding the audit of antibiotic prescribing to include prescribing by GPs.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care