21 May 2019
Kingston General Practice (GP) Chambers is a federation of all 21 NHS GP practices within the Royal Borough of Kingston upon Thames. The federation works collaboratively with secondary care and the private sector in order to provide community clinics for dermatology, urology, dementia and diabetes. They also provide an extended hours GP appointments service on weekday evenings, over the weekends and on Bank Holidays across three hubs. Further details about the Chambers’ can be found on their website: www.KGPC.org.uk.
Merritt Medical Centre is located at Merritt Gardens, Chessington, Surrey, KT9 2GY. The site delivers daily extended hours GP appointments and a diabetes clinic.
Extended hours GP appointments are available from this site from 5pm to 8pm Monday to Friday, and 8am to 2pm on Saturdays and Sundays. Nurse led diabetes clinics are run on two Thursdays per month, appointments with a GP and a dietician are available on one Thursday per month.
The site operates from a two-storey purpose built premises, which also houses two regular GP practices and a range of community services. Car parking is available on-site. The reception desk and waiting area is situated on the ground floor, and consultation rooms are situated on the first floor. Two consulting rooms are used by the Chambers.
Staff employed by the Chambers who work from the Merritt Medical Centre site include GPs working for the extended hours service, and two GPs, a diabetes nurse and a dietician working for the diabetes clinic, reception/administrative staff and a service manager.
This location was visited and inspected as part of our overall inspection of Kingston GP Chambers. Our inspection team was led by a CQC lead inspector. The team included a second CQC Inspector, a GP specialist advisor and a nurse specialist advisor.
21 May 2019
This service is rated as Good overall. This service has not been inspected previously.
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 Kingston General Practice Chambers on 14 and 15 March 2019 as part of our inspection programme; this included visiting and inspecting all three of the Chambers’ registered locations. Merritt Medical Centre was visited as part of this inspection on 14 March 2019.
At this inspection we found:
- The service had good systems to manage risk so that safety incidents were less likely to happen; however, in some areas policies and procedures required review, and the service was in the process of addressing this at the time of the inspection. We saw evidence that when safety incidents did happen, the service learned from them and improved their processes.
- The service routinely reviewed the effectiveness and appropriateness of the care it provided. These reviews provided some assurance that care and treatment was being delivered according to evidence-based guidelines; however, in respect of the extended hours service, the audit programme did not include wide-scale reviews, for example, to ensure appropriate antibiotic prescribing.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
- Review the risk assessment process in respect of pre-employment Disclosure and Barring Service checks.
- Review the arrangements in place for ensuring that medicines are prescribed according to appropriate guidance, in particular, in relation to monitoring antimicrobial prescribing and ensuring a fully documented audit trail of the handling of medicines and safety alerts.
- Review the information provided to staff in respect of reporting significant events to ensure that all staff are aware of the location of the reporting form.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care