Archived: CP Medical Clinic

Updated 15 April 2019

CP Medical Clinic is a private doctor's consultation service for adults and children in the Royal Borough of Kensington and Chelsea. Dr David O’Connell is registered as an individual provider with the Care Quality Commission to provide the regulated activity of treatment of disease, disorder or injury. Regulated activities are provided at one host clinic location, 61-63 Sloane Avenue, London SW3 3DH.

The host clinic premises are located on the ground floor and in the basement of a converted residential property. The host clinic is not registered with or regulated by CQC, though CP Medical had adopted some of its policies and processes. The premises are leased by the director of the host clinic. There is a shared entrance, three consultations rooms, a waiting area, reception and toilet facilities. The director of the host clinic runs a pharmacy on the ground floor.

General medical services provided include routine medical consultations and examinations, vaccinations and travel vaccinations and health screening. There are 20-30 consultations carried out weekly.

Medical services at the host clinic are provided by the registered provider, eleven private doctors and four specialist consultants. The work of the other doctors and consultants does not form part of this inspection. The registered provider works 16 hours a week at the service and performs approximately 12 consultations a week there, the other consultations being performed by the other doctors. Dr O’Connell’s service is open between 9am – 9pm, Monday to Saturday and 4pm – 8pm on Sunday. There is a service manager who oversees all administrative and managerial duties at the host clinic. The host clinic employs a team of part time reception staff who receive Dr O’Connell’s patients when they arrive for an appointment.

How we inspected the service:

Our inspection team on 4 February 2019 was led by a CQC Lead Inspector and included a GP specialist advisor and a second CQC inspector.

Before visiting, we reviewed a range of information we hold about the service.

As part of the inspection we:

• Spoke with clinical and non-clinical staff including the registered provider, service director and administrative staff.
• Reviewed an anonymised sample of the personal care or treatment records of patients.
• Reviewed service policies, procedures and other relevant documentation.
• Looked at the systems in place for the running of the service.

On this focussed inspection we asked the following question about the service:

• Is it Safe?
• Is it Well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 15 April 2019

We carried out an announced comprehensive inspection at CP Medical Clinic on 11 December 2018 to follow up the concerns identified at our previous inspection in June 2018. You can find the reports of our previous inspections by selecting the ‘all reports’ link on our website.

This inspection was an announced focused inspection carried out on 4 February 2019 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified at our previous inspection on 11 December 2018.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This report covers our findings in relation to those requirements and improvements made since our last inspection.

CP Medical Clinic provides private medical services at 61-63 Sloane Avenue in the Royal Borough of Kensington and Chelsea and treats adults and children. The provider, Dr David O’Connell is registered with CQC under the Health and Social Care Act 2008 to provide the regulated activity of Treatment of disease, disorder and injury at this location.

At this inspection we found action had been taken on most of the issues identified at the previous inspections.

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

Our key findings were:

• The service had succeeded in making improvements to most aspects of policy and protocol, but there were areas for improvement identified. The provider was not consistently following policies and procedures used by staff at the host clinic.
• The service had reviewed risks associated with the service’s premises and ensured formal safety risk assessments were carried out at regular intervals to reduce risks to patients and staff.
• Management of fire risk kept people safe. The service had maintained a record of fire drills as outlined in the fire risk assessment.
• The provider monitored people on high-risk medicines. Records we looked at showed patients’ health was monitored in relation to the use of medicines and followed up on appropriately.
• The provider had started to implement a system to ensure the safe management of prescribing of controlled drugs.
• Records were not always written and managed in a way to keep people safe. Patient notes were not easily accessible in an emergency and it was not possible for the provider to share information with other services when there was an urgent need.
• CCTV cameras in the two consulting rooms had been removed. The provider did not have signs up warning people about CCTV recording in the host clinic. Staff put up signs during our inspection.
• There was no employee record for one member of staff who was employed by the provider in the carrying on of regulated activities and no record of a DBS check. During our inspection, the provider was able to obtain evidence of DBS disclosure application for the employee.
• Governance arrangements had improved to ensure effective oversight of risk. There was a controlled drugs policy in place and leaders had completed priority actions from the fire safety risk assessment.

We identified regulations that were not being met and the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review ease of access to patient notes kept by the provider.
• Continue to develop quality improvement systems that monitor the positive impact on quality of care and patient outcomes.
• Review the systems for checking expiry dates on medicines stored by the provider.
• Review the process for sourcing patient feedback to improve and develop the service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care