The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Thyagarajagopalan Krishnamurthy

Overall: Good read more about inspection ratings

East Ham Memorial Hospital, Shrewsbury Road, Forest Gate, London, E7 8QR (020) 8586 6555

Provided and run by:
Dr Thyagarajagopalan Krishnamurthy

Important: The provider of this service changed. See new profile

All Inspections

1 December 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Thyagarajagopalan Krishnamurthy on 9 August 2016. The overall rating for the practice was good. However, the rating for the practice providing safe services was requires improvement and we found six areas where the provider should make improvements that mostly related to safety. The full comprehensive report on the 9 August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Thyagarajagopalan Krishnamurthy on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 1 December 2017 to check that the provider had made improvements and to confirm that they met requirements. This report covers our findings in relation to the areas where the provider should make improvements.

Overall the practice remains rated as good overall and requires improvements for providing safe services.

Our key findings were as follows:

  • The practice did not have an effective process for identifying and managing significant events.
  • The practice had liaised with relevant health and social care professionals to identify children at risk but systems were not in place to identify and flag vulnerable patients.
  • Medicines including emergency medicines were stored appropriately.
  • Prescription pads were securely stored and monitored.
  • The practice had improved patients telephone access by staggering opening up of appointments throughout the day, to manage incoming calls activity and allow better access to appointments for patients calling later in the day.
  • The practice had completed a programme of clinical audit improve outcomes for patients.
  • Patients with caring responsibilities were identified and received appropriate support. For example, the practice had identified 1% of its patient list as carers that were given priority appointments and offered annual flu vaccinations, as well as signposting to local support groups and services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

9 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Krishnamurthy’s Practice on 9 August 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety however we did not find evidence of robust incident and significant event identifying, recording or learning.

  • Risks to patients were assessed and well managed.
  • 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.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services was available and easy to understand, however information about how to complain was not available.
  • Patients 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.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

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

  • Review the practice’s telephone system to improve patient access.

  • Introduce a broader programme of clinical audits including re-audits to ensure that improvements are measurable.

  • Make arrangements to ensure appropriate security and monitoring of prescription pads.

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

Continue to liaise with safeguarding team to identify vulnerable children

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

31 July 2014

During a routine inspection

Dr Thyagarajagopalan Krishnamurthy provides a general practice service to just over 2,000 patients in the East Ham area of Newham. There is one GP, a part time salaried GP and part time nurse.

We carried out an announced inspection on 31 July 2014. We spoke with 14 patients during our visit and received 44 comment cards completed by patients who visited the surgery during the two weeks before our visit. Patients comments about the care and treatment they received were positive, they felt they were respected, their dignity and privacy maintained and said staff were kind, caring and helpful. The few negative comments were about the environment, getting through on the telephone to make an appointment and having to wait when they attended their appointment. We met with NHS England and Newham Clinical Commissioning Group before our visit.

The practice had a higher than national and local average number of older patients. The practice had a named GP for patients over 75 and a system to review medication at least annually to ensure it remained appropriate. The practice was accessible to patients with mobility issues and those who used a wheelchair. The practice kept a register of patients with long term conditions and suitable systems in place to review treatment plans to check they were working and no new conditions were developing. There were suitable child protection procedures and staff were trained to the appropriate Level and aware of their responsibilities to report issues and concerns. The practice offered health checks and immunisations in line with the ‘healthy child programme’. The CCG had identified two local GP practices to provide services to patients who were homeless and while Dr Krishnamurthy was not one of these, he said he would see patients if it was urgent. There were regular meetings with the local mental health services to provide joined up care to people experiencing poor mental health.

The provider was in breach of regulations related to: staff recruitment because records did not confirm that the required checks had been made (lack of references, proof of identity and Disqualification and Barring Scheme checks); management of medicines because we found out of date medicines and emergency medicines (limited recording of fridge temperatures) and cleanliness and infection control because there was no written cleaning schedule and details of cleanliness checks to made. Improvements were required to the systems for reporting incidents to ensure all significant events were recorded and the learning could be shared with all staff. A safeguarding vulnerable adults policy must be in place.

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.