Archived: Dr Sunil Srivastava Also known as Richmond Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sunil Srivastava (Richmond Medical Centre) on 14 October 2014.  During the inspection we gathered information from a variety of sources. We spoke with patients, interviewed staff at all levels and checked that the right systems and processes were in place.

Overall the practice is rated as inadequate and improvements must be made. This is because we found it inadequate for providing safe, effective and responsive services and being well led. It was also inadequate for providing services for all the population groups:

• Older people
• People with long term conditions
• Families, children and young people
• Working age people (including those recently retired and students)
• People whose circumstances make them vulnerable
• People experiencing poor mental health (including people with dementia)

Improvements were also required for providing caring services. 

Our key findings were as follows:

• Risks to some patients who used services were identified and assessed but systems and processes to address these issues were not implemented in a way to identify risks and keep them safe.
• Appropriate recruitment checks on staff had not been undertaken prior to their employment, for example criminal records checks (Disclosure and Barring Service - DBS).
• Urgent appointments were usually available on the day they were requested. However, we found that the routine appointment system was not working, as patients experienced difficulty getting through on the telephone and were often waiting long periods of time when attending for their appointment.  
• There was no evidence of completed audit cycles. 
• The practice had no lead for infection control and there had been no recent infection control audits undertaken.  Actions identified by an independent contractor had not been addressed.
• Most patients were positive about their interactions with staff and said they were treated with compassion.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements are in place that includes all necessary employment checks for all staff.
• Ensure review systems for assessing and monitoring the quality of the service provision and take steps to ensure risks are managed appropriately.
• Ensure there are formal governance arrangements in place and staff are aware of how to implement these to ensure the practice functions in a safe and effective manner. 
• Ensure staff have appropriate policies and guidance to carry out their roles in a safe and effective manner which is reflective of the requirements of the practice.
• Ensure that the practice understands the requirements with respect to consent and capacity and ensure they always act in accordance with the consent of patients.
• Ensure the practice has in place a sufficient number of administrative staff in order to facilitate the smooth running of the practice and to safeguard the health, safety and welfare of patients.
• Take action to address infection prevention and control to ensure the practice complies with the ‘Code of Practice for health and social care on the prevention and control of infection and related guidance’.
• Ensure patients’ dignity and privacy is maintained in relation to their care and treatment.
• Ensure patients’ medical records and personal details are held securely and remain confidential.

The practice will have six months to make the improvements required by this report.  We will carry out a further inspection at the end of that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice