The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Philip Olufunwa Also known as The Westbourne Green Surgery

Overall: Requires improvement read more about inspection ratings

Health At The Stowe, 260 Harrow Road, London, W2 5ES (020) 3405 6580

Provided and run by:
Dr Philip Olufunwa

All Inspections

11 August 2022

During an inspection looking at part of the service

We carried out a focused inspection of Dr Philip Olufunwa’s practice at Westbourne Green Surgery on 11 August 2022. This was an unrated inspection to follow-up non-compliance.

Following our previous inspection on 1 April 2022, the practice was rated requires improvement overall and for the key questions of safe, effective and well-led. The practice was rated as good for providing caring and responsive services. We issued a warning notice to the practice requiring it to improve the safety of its service by 1 August 2022.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Philip Olufunwa on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up a breach of regulations from a previous inspection. We did not rate any key questions at this inspection.

At this inspection we focused on the concerns identified at the previous inspection:

  • recruitment processes;
  • assessment and mitigation of environmental risks;
  • readiness for medical emergencies;
  • systems for clinical oversight;
  • the management of patients with long-term conditions;
  • monitoring of patients prescribed higher risk medicines;
  • implementation of national patient safety alerts; and
  • adequacy of staffing levels.

How we carried out the inspection

This inspection was carried out with a site visit on 11 August 2022 alongside remote clinical searches. The methods included:

  • Conducting a mix of online and face-to-face interviews with the provider and staff.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Reviewing other documentary evidence of policies and processes.
  • Observation of the safety of the premises and equipment.

Our findings

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 found that:

  • The practice had addressed some but not all the concerns identified at the previous inspection. For example, the monitoring of patients on higher risk medicines had improved.
  • The practice was generally providing clinical care in line with guidelines. The management of patients with hypothyroidism had improved but we found continuing issues in relation to the management of patients with diabetic retinopathy.
  • The practice had not satisfactorily implemented one of the national patient safety alerts that we reviewed.
  • The practice could not yet demonstrate that it had effective systems in place to identify and manage risks to patients and staff, for example it had not completed all required recruitment checks at the time of the inspection.
  • Evidence of clinical oversight and supervision was still not being documented.
  • The practice leadership had not stabilised clinical staffing prior to the inspection resulting in continued staff turnover, staff stress and periods when patient access to the service had been limited.
  • The provider had sought external assistance since our previous inspection. The provider was in the process of moving to a formal partnership with a neighbouring practice.

We found a continuing breach of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

1 April 2022

During an inspection looking at part of the service

We carried out an announced inspection at Westbourne Green Surgery from 30 March to 7 April 2022. Overall, the practice is rated as requires improvement.

The ratings for each key question:

Safe - Requires improvement

Effective – Requires improvement

Well-led – Requires improvement

Following our previous inspection on 22 June 2017, the practice was rated good overall and for all key questions. The ratings for the caring and responsive key questions are carried forward from the previous inspection.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Philip Olufunwa on our website at www.cqc.org.uk.

Why we carried out this inspection

This inspection was a focused inspection to follow up on concerns received by CQC about the practice. The focus of the inspection included the following:

  • The key questions: Is the service safe, effective and well-led?
  • Access to the practice during pandemic

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Reviewing patient records to identify issues and clarify actions taken by the provider
  • Requesting evidence from the provider
  • A short site visit

Our findings

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 requires improvement overall

We found that:

  • The practice did not have fully embedded systems in place to identify and manage risks to patients and staff. For example, there were missing records of staff criminal records checks; variable systems to ensure the safe management of medicines; and environmental risks were not yet fully assessed.
  • The practice was generally providing clinical care in line with guidelines but we found issues in relation to the coding or management of some longer-term conditions including asthma, hypothyroidism and chronic kidney disease. There was a backlog of delays to long-term condition reviews. Clinical oversight and supervision were not documented and practice performance for childhood immunisations was below average.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
  • The practice leadership had failed to respond promptly to major risks to the service early in the year. Issues at that time included ineffective governance systems; poor performance; performance monitoring; and unexpected staff absence. The provider had recognised the problems and subsequently recruited more staff and the practice was in the process of recovery. We saw evidence of significant improvement, but we remained concerned about the team’s resilience to any future shocks.

We found breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition, the provider should:

  • Continue to work to improve uptake of childhood immunisations and cancer screening programmes.
  • Ensure materials for locum staff are up-to-date.

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

22 June 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Philip Olufunwa on 22 October 2015. The overall rating for the practice was requires improvement. The full comprehensive report on the October 2015 inspection can be found by selecting the ‘all reports’ link for Dr Philip Olufunwa on our website at www.cqc.org.uk.

This inspection was undertaken to check the provider had taken the action we said they must and should take and was an announced comprehensive inspection on 22 June 2017. Overall the practice is now rated as good.

Our key findings were as follows:

  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • The practice had taken the action we said it must take at our October 2015 inspection to ensure all appropriate pre-employment checks were carried out and recorded in staff records.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. The practice had taken the action we said it should take at our October 2015 inspection to ensure evidence of child safeguarding training was held in the practice records for all locum staff.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Not all patients we spoke with said they found it easy to make an appointment with a named GP but there was continuity of care, with walk clinics, urgent appointments and GP telephone consultations available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

  • Continue action to improve QOF performance in areas where performance has been below CCG and national averages.
  • Ensure more rapid progress in the introduction of care plans for patients over 75, those at risk of hospital re-admission and patients with complex problems.
  • Make further improvement in recording the process for seeking consent to ensure the process is fully documented in patient records.
  • Provide appropriate briefing and instruction to ensure all staff are aware of the duty of candour requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

22 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Philip Olufunwa on 22 October 2015. Overall the practice is rated as Requires Improvement.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Our key findings were as follows:

  • Staff were clear about reporting incidents, near misses and concerns and there was evidence of communication of lessons learned with staff.

  • 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.

  • There was limited evidence of practice initiated clinical audit and re-audit to improve patient outcomes.

  • There were shortcomings in the practice’s recruitment processes.

  • The practice promoted good health and prevention and provided patients with suitable advice and guidance. However, the introduction of care plans and annual checks for some at risk groups was in the early stages.

  • The practice provided a caring service. Patients indicated that staff were caring and treated them with dignity and respect. Patients were involved in decisions about their care.

  • The practice provided appropriate support for end of life care and patients and their carers received good emotional support.

  • The practice learned from patient experiences, concerns and complaints to improve the quality of care.

  • There was an open culture and staff felt supported in their roles.

The areas where the provider must make improvements are.

  • Ensure patients are fully protected against the risks associated with the recruitment of staff; in particular in ensuring all appropriate pre-employment reference checks are carried out and recorded in staff records.

In addition the provider should:

  • Arrange for the practice’s policy on safeguarding of vulnerable adults to include details of local agencies to contact for further guidance if staff have concerns about a patient’s welfare.

  • Ensure evidence of child safeguarding training is held in the practice’s records for all temporary locum doctors.

  • Ensure disposable privacy curtains in consulting rooms are changed after six months in accordance with national guidance

  • Consider carrying out a monthly check of the single thermometer in the vaccines fridge to confirm that the calibration is accurate, in line with the national guidance; and ensure the vaccine fridge is not overstocked, to avoid inhibiting air flow and circulation.

  • Complete the introduction of care plans for patients over 75, those at risk hospital of re-admission and patients with complex problems.

  • Carry out clinical audits and re-audits to improve patient outcomes.

  • Ensure the completion of: systematic recall for the review of all patients with long term conditions; and the annual health checks for patients diagnosed with dementia and those with learning a learning disability, for all patients due them.

  • Ensure discussion of informed consent for medical procedures is recorded in the patient’s notes in all cases.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

17 June 2013

During a routine inspection

We spoke with six people who used the service and looked at comments from people on the NHS Choices website. Overall people were satisfied with the service. Most people told us they could get an appointment when they needed one and found staff to be helpful. People told us they "trusted" their GP and one person told us they "take their time with me". There was an Arabic interpreter based at the practice and people had a choice of either a male or female GP.

People received care and treatment, including medication, that ensured their safety and welfare. People were assessed and treated by a qualified clinician who arranged for diagnostic tests to be carried and referred people to other services or specialists, where necessary. Staff had received basic life support training and there was emergency equipment available.

There were systems in place to monitor the quality of service provided and to ensure that medicines were safely ordered, stored and disposed of. People's records were accurate and fit for purpose. If people were prescribed medication or had an immunisation, this was recorded in their notes. Medical records were securely stored and only accessible to authorised members of staff. The provider was required to submit evidence of audits, investigations of incidents and complaints to the local Clinical Commissioning Group (CCG) in order to demonstrate how he was meeting certain quality indicators. Clinical meetings also took place to discuss individual cases.