Background to this inspection
Updated
19 December 2019
LivingCare Medical Services – Soho Square General Practice, provides GP primary medical services to approximately 4617 patients living in the London Borough of Westminster. This service was commissioned by NHS Central London Clinical Commissioning Group (CCG). The service is located on the first floor along with another practice, a walk-in centre and a dentist.
There is a lift to all floors, baby changing facilities and step free access.
The patient population groups served by the practice include a cross-section of socio-economic groups with a high prevalence of patients from Chinese ethnic backgrounds which accounts for 20% of the patient population. 58% of their patients with English listed as their first language. Information published by Public Health England, rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice has a 44% female population with a large percentage of patients in the 30-39 years (28%) age group and 5% of the population is under 10 years old.
The practice team comprises of two full time GP’s, one male and one female both providing 13 sessions per week and two male locum GP’s providing six and two respectively. There is a full time practice nurse and here a long-term female locum practice nurse working three days a week. There is a practice manager, and assistant practice manager and four administrative staff.
The practice is open between 8am-6.30pm Monday to Friday and 9am-1pm on Saturdays. Home visits are provided for patients who are housebound or too ill to visit the practice. The practice refers patients to the London Central and West Out of Hours and the NHS ‘111’ service for healthcare advice during out of hours.
The practice is registered with the Care Quality Commission to provide the regulated activities of maternity and midwifery services; diagnostic and screening procedures; treatment of disease, disorder or injury.
The practice runs a number of services for its patients including; chronic disease management, new patient checks, smoking cessation, phlebotomy, 24-hour blood pressure monitoring, travel vaccines and advice.
Services are provided from one location:
Soho Square General Practice
First Floor
1 Frith Street
London
W1D 3HZ
The practice website is
Updated
19 December 2019
We carried out an announced comprehensive inspection at Soho Square General Practice on 31 October 2019 as part of our inspection programme.
At this inspection we followed up on breaches of regulations identified at a previous inspection on 7 March 2019.
On that inspection we found;
- Patients on high risk medicines were monitored and blood tests were undertaken however there was no evidence that the appropriateness of the ongoing prescribing was being reviewed.
- The standard of cleaning in some rooms was not up to healthcare premises standards.
- The practice did not always learn and make improvements when things went wrong.
- Low childhood immunisation and of cervical screening uptakes.
- Some performance data was significantly below local and national averages.
- No long term conditions training for the locum nurse.
- The practice did not always have clear and effective processes for managing risks, issues and performance.
- The practice did not always act on appropriate and accurate information.
- The overall governance arrangements were ineffective.
- The practice did not always have clear and effective processes for managing risks, issues and performance.
- We saw little evidence of systems and processes for learning, continuous improvement and innovation.
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:
- The practice had an effective system for managing patients on medicines that needed monitoring.
- Staff involved in treating patients with long term conditions had the appropriate training for this role.
- The monitoring and the standard of cleaning had improved.
- Quality Outcomes Frameworks (QOF) had improved since the last inspection.
- Local managers had improved the processes for managing risks, quality improvement and the dissemination of learning from incidents.
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way. However, the patient participation group felt better access to a Chinese speaking GP would be helpful considering the patient population.
- The practice worked in collaboration with other health and social care professionals to support patients’ needs and provided a multidisciplinary approach to their care and treatment.
- The practice provided appropriate support for end of life care and patients and their carers received good emotional support.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
- There was an open culture and staff felt supported in their roles, all staff had received annual appraisals.
Whilst we found no breaches of regulations, the provider should:
- Ensure staff had the appropriate authorisations to administer medicines (including Patient Group Directions or Patient Specific Directions).
- Continue to review systems to monitor and improve cancer screening rates and look at ways to improve this.
- Review the arrangements for having a GP who spoke Mandarin and Cantonese to better serve this patient group.
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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