Dr Kumaran & Partners Also known as Queens Park Medical Practice

Updated 13 September 2018

Dr Kumaran & Partners, also known as Queens Park Medical Centre, is an NHS GP practice located in Feltham, Middlesex. The practice is part of NHS Hounslow Clinical Commissioning Group (CCG) and provides GP led primary care services through a Personal Medical Services (PMS) contract to approximately 5,000 patients. (PMS is one of the three contracting routes that have been available to enable commissioning of primary medical services).

Services are provided from:

• Feltham Centre for Health, High Street, Feltham, Middlesex, TW13 4GU

Online services can be accessed from the practice website:

• www.queensparkmedical.co.uk

The practice is led by two GP partners (male and female) who are supported by: two GP locums (male and female); a practice nurse (female); a health care assistant (female); a practice manager; and three receptionists / administrators.

The practice has a higher percentage of patients aged under 18 years compared to the local and England average. The practice area is rated in the fifth deprivation decile (one is most deprived, ten is least deprived) of the Index of Multiple Deprivation (IMD).

The practice is registered with the Care Quality Commission to provide the regulated activities of: diagnostic and screening procedures; maternity and midwifery services; family planning; surgical procedures; and treatment of disease disorder and injury.

Updated 13 September 2018

We carried out an announced comprehensive inspection at Dr Kumaran & Partners, also known as Queens Park Medical Centre on 24 July 2017. The practice was rated as requires improvement for providing caring services as the practice had not reviewed or taken action on

results from the national GP patient survey 2016 and 2017. The overall rating for the practice was good. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all reports’ link for Dr Kumaran & Partners on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 21 August 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 24 July 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good for providing caring services. Overall the practice remains rated as good.

Our key findings were as follows:

• The practice had reviewed and taken action on results from the national GP patient survey 2016 and 2017. They had also reviewed data from the 2018 survey.
• The practices GP patient survey results 2018 were mostly in line with local and national averages. The practice had reviewed this data and created an action plan to improve patient satisfaction.
• There was now a system to identify how often training should be completed to ensure staff were up-to-date.
• The practice now acted on and learned from external safety events as well as patient and medicine safety alerts.
• The business continuity plan was now more accessible to staff.
• There was now a system to record verbal references for new staff.
• Interpretation services were available for patients who did not have English as a first language and this was now advertised in the waiting area.
• The practice had a realistic strategy and supporting business plans to achieve priorities.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 4 September 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff supported the GPs in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The practice had performed well on the Quality and Outcomes Framework (QOF) for managing most long-term conditions. For example, performance for diabetes related indicators was similar to the clinical commissioning group (CCG) and national averages.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs. The practice also had a bypass number available for A&E clinicians and ambulance staff.
• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 September 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.
• Immunisation rates were comparable to CCG and national averages for all standard childhood immunisations.
• Young people aged 17-18 were invited to receive a meningitis vaccination as part of a local enhanced service.
• Chlamydia screening was included in health checks for new patients if required.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• GP appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to support this population group.
• The practice offered family planning, contraception and maternity advice services.
• The practice had emergency processes for acutely ill children and young people.

Updated 4 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population. All patients aged over 75 had been allocated a named GP.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example, the practice ran campaigns to encourage eligible patients to have the flu, shingles and pneumococcal vaccinations.
• The practice worked collaboratively with other healthcare professionals in providing care and services to older people with complex needs. For example, utilising primary care coordinators to increase the quality in care planning.

Updated 4 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours until 8pm on Monday and Tuesday evenings for consultations with a GP.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 4 September 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice carried out advance care planning for patients living with dementia.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• In 2015/16, 83% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 86% and national average of 84%.
• In 2015/16, 88% of patients with a diagnosed psychosis had a comprehensive care plan in their records, which was comparable to the CCG and national averages of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Clinical staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 4 September 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability, and these patients had a named GP.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.