The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Maria Coutinho Also known as Trinity Medical Centre

Overall: Requires improvement read more about inspection ratings

213 Burrage Road, Plumstead, London, SE18 7JZ (020) 8319 7640

Provided and run by:
Dr Maria Coutinho

Important: This service is now registered at a different address - see new profile

All Inspections

22 August 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Maria Coutinho on 13 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on 13 July 2016 can be found by selecting the ‘all reports’ link for Dr Maria Coutinho on our website at www.cqc.org.uk.

Since the 13 July 2016 inspection the registered provider has moved location from 213 Burrage Road Plumstead London SE18 7JZ to 2 Garland Road Plumstead London SE18 2AE.

This inspection was an announced comprehensive inspection on 22 August 2017. Overall the practice remains rated as requires improvement.

Our key findings were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • All practice policies and procedures had been updated.
  • The practice had purchased a defibrillator, and all staff had been trained on how to use it.
  • The provider was aware of and complied with the requirements of the Duty of Candour. Examples we reviewed showed the practice complied with these requirements.
  • No full cycle audits had been conducted.
  • Immunisation rates were slightly below average for all standard childhood immunisations.
  • Patients did not have care plans in place.
  • Fridge temperatures were monitored, however there was only an internal thermometer being used and it was not calibrated frequently. This is not in accordance with Public Health England guidance.
  • 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.
  • 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.
  • Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments 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.

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

Importantly, the provider must:

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

  • Do all that is reasonably practicable to mitigate any such risks.

  • Ensure quality improvement programmes are conducted to improve patients’ outcome.

  • Ensure there is a system in place to monitor safety alerts.

  • Ensure that patients who require care plans have them.

  • Ensure staff are up to date with training.

  • Ensure systems are in place to review clinical staff registration details and medical insurance annually.

  • Ensure registration regulated activities are updated.

In addition the provider should:

  • Review temperature monitoring on the medicine fridge to make sure it is in line with current guidance.

  • Continue to review antibiotic prescribing.

  • Continue to try and obtain emergency medicine Hydrocortisone.

  • Update their business continuity plan.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

13 July 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 13 July 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

  • The practice premises were in a generally poor condition. Risk assessments of the premises had identified concerns with health and safety, accessibility and infection control. The practice told us they could not fully resolve these concerns while the current premises were in use. The practice told us they had secured agreement to relocate to new premises, but no date had been set at the time of the inspection.

  • There was an open and transparent approach to safety but there was no effective system in place for reporting and recording significant events.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

  • Practice performance data showed patient outcomes were comparable to the national average.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

  • Patients said they generally found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

  • The practice had a number of policies and procedures to govern activity, but some were undated; therefore it was not clear when they had been written or when they were due for review.

  • 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 not aware of the requirements of the duty of candour, although we saw that when things went wrong patients received reasonable support, truthful information, and a written apology.

The areas where the provider must make improvements are:

  • Take action to address identified concerns with the physical environment relating to infection control, accessibility and health and safety.

  • Introduce robust processes for reporting, recording, acting on and monitoring significant events, incidents and near misses.

  • Ensure there is a defibrillator available on the premises, or carry out an assessment of the risks to patients associated with the decision not to have one.

In addition the provider should:

  • Ensure all policies and procedures in the practice are up to date and regularly reviewed.
  • Ensure the provider and staff are familiar with the CQC duty of candour and understand their responsibilities in relation to it.

  • Ensure that any individual providing an interpreting service on behalf of a patient is competent and suitable to carry out that role, in order that all patients are able to give informed consent to care and treatment.

  • Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

  • Ensure response letters to complaints provide details of the local health service ombudsman or other avenues for patients to pursue if they are not happy with the outcome.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

11 April 2014

During an inspection looking at part of the service

People that we spoke with told us they were happy with the care they received and felt well informed about decisions relating to their care. One person told us "the doctor is friendly, understands my needs and my consultation was undertaken in a closed room'. Another person told us " there is a long waiting time to see my preferred doctor but it is quicker to see other doctors. Receptionist staff are polite except one particular person'. We found people's views were taken into account in the way the service was delivered and their dignity and privacy was respected on most occasions. The provider had suitable recruitment procedures in place to ensure satisfactory checks had been completed for all employed staff.

10 June 2013

During a routine inspection

We spoke to members of the Patient Participation Group and people visiting the surgery on the day of our inspection. People told us they were happy with the service provided by the doctors at the practice. A person described one of the GPs as "five star" and two people described the GP as "brilliant". Another person told us they had been treated "really well". People told us the GPs were approachable and they could ask questions if they needed to. We found that people's care was planned and delivered in a way that met their individual needs and that the practice co-operated with other healthcare professionals and services. We also found that people were protected from the risk of abuse because the provider had procedures in place for safeguarding vulnerable adults and children and staff we spoke with were aware of these procedures.

Some people we spoke with on the day of our inspection told us they had been able to make an appointment which suited them on that day. However other people told us it was difficult to get an appointment with the GP of their choice. People we spoke with had mixed views about the reception staff at the practice. Some people said staff were helpful and polite and others told us reception could be 'abrupt'. We also found that people's privacy and dignity was not respected in every case.

We found that the provider did not have effective recruitment procedures in place to ensure only suitable staff were employed at the service.