Background to this inspection
Updated
18 July 2019
Dr Kandiah Pathmanathan’s practice, also known as the Covent Garden Medical Centre, operates from 47 Shorts Gardens, London WC2H 9AA. The premises are leased from the local authority and occupy the ground floor of a residential block.
The practice provides NHS primary medical services through a General Medical Services (GMS) contract to approximately 3,200 patients. It is part of the NHS Central London (Westminster) Clinical Commissioning Group (CCG) which is made up of 37 general practices. Eight percent of patients are aged under 18 (compared to the national practice average of 21%) and 15% are 65 or older (compared to the national practice average of 17%). Forty nine percent of patients have a long-standing health condition. The services provided by the practice include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions.
The staff team comprises three salaried GPs (two males, one female) equating to a 1.5 full time post, two female part time practice nurses, a female healthcare assistant, a practice manager a team of administrative staff and one managing GP principal.
Opening hours
Monday 8.00 am – 1.00 pm and 2.00 pm – 6.30 pm
Tuesday 8.00 am – 1.00 pm and 2.00 pm – 6.30 pm
Wednesday 8.00 am – 1.00 pm and 5.00 pm – 6.30 pm
Thursday 8.00 am – 1.00 pm and 2.00 pm – 6.30 pm
Friday 8.00 am – 1.00 pm and 2.00 pm – 6.30 pm
Consultation times
Monday 9.00 am – 12.00 noon 3.00 pm – 6.30 pm
Tuesday 9.00 am – 12.00 noon 3.00 pm – 6.30 pm
Wednesday 9.00 am – 12.00 noon 5.30 pm – 6.30pm
Thursday 9.00 am – 12.00 noon and 5.30 pm – 6.30 pm
Friday 8.00 am – 12.00 noon and 3.00 pm – 6.30 pm
8am-8pm weekend appointments are also available.
Outside of the above times, cover is provided by an out of hours provider.
Updated
18 July 2019
We carried out an announced comprehensive inspection at Dr Kandiah Pathmanathan (also known as Covent Garden Medical Centre) on 16 May 2019.
We had previously inspected Dr Kandiah Pathmanathan’s practice using our new approach methodology on 5 March 2015, when we had rated the service as requires improvement. We carried out a further announced comprehensive inspection on 8 November 2016.
The overall rating for the service was inadequate and the practice was placed in special measures for a period of six months. We had found that patients were at risk of harm because systems and processes were not in place in a way to keep them safe.
We carried out a focussed inspection on 18 May 2017 and identified other concerns relating to safe care and treatment. Following the period of special measures, we carried out an announced comprehensive inspection on 8 August 2017. We found that although the practice had achieved significant improvement, concerns remained regarding GP national survey patient satisfaction scores and regarding patient outcomes, such that the practice was rated as requires improvement relating to a failure to comply with Regulation 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The improvements were sufficient however, for the service to be taken out of special measures. We carried out an announced comprehensive inspection on 10 October 2018 to follow up on these identified breaches of regulations and asked the provider to make improvements because although the care being provided was effective, caring, responsive and well led, it was not being provided in accordance with the relevant regulations relating to safe care.
Specifically, we found the provider had breached Regulation 12 (1) (Safe care and treatment). This was because dosage and patient assessment information contained in the practice’s Patient Specific Directions were not being checked and signed by a registered prescriber prior to their use by the practice’s Health Care Assistant.
Shortly thereafter the service wrote to us to tell us what they would do to make improvements. We undertook this comprehensive inspection to check the service had followed their plan and to confirm they had met the legal requirements.
At the time of our 16 May 2019 inspection, Dr Kandiah Pathmanathan had recently retired and transferred their NHS contract to a new principal GP who was in the process of deregistering the location and registering as a new CQC location.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good for all population groups.
We found that:
- Action has been taken since our last inspection such that staff now had the appropriate authorisations to administer medicines.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- Patients could access care and treatment in a timely way.
- Although we identified some governance concerns regarding safeguarding and regarding how incoming correspondence was actioned, overall the way the practice was led and managed promoted the delivery of high-quality, person-centre care.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor and take action to improve national GP patient survey satisfaction on the extent to which staff treated patients with care and concern.
- Continue to monitor and take action to improve patient outcomes regarding childhood immunisations.
- Continue to monitor recently introduced protocols for safeguarding vulnerable patients and managing incoming correspondence.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care