• Doctor
  • GP practice

Dr K Manivannan & Dr B Gurung Also known as Thames Avenue Surgery

Overall: Good read more about inspection ratings

2 Thames Avenue, Rainham, Gillingham, Kent, ME8 9BW (01634) 360486

Provided and run by:
Dr K Manivannan & Dr B Gurung

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Dr K Manivannan & Dr B Gurung on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Dr K Manivannan & Dr B Gurung, you can give feedback on this service.

9 May 2023

During an inspection looking at part of the service

We carried out an announced focussed inspection at Dr K Manivannan & Dr B Gurung on 9 May 2023. The overall rating for the practice is good.

The ratings for each key question are:

Safe – good.

Effective – good.

Caring – good.

Responsive – good.

Well-led – good.

Following our inspection on 20 May 2022, the practice was rated good overall and for providing effective, caring, responsive and well-led services. The practice was rated as requires improvement for providing safe services. A requirement notice was issued for breaches of regulation found at this inspection.

The full reports for the May 2022 inspection can be found by selecting the ‘all reports’ link for Dr K Manivannan & Dr B Gurung on our website at www.cqc.org.uk.

Why we carried out this inspection:

We carried out this inspection to follow up on breaches of regulation from our previous inspection.

How we carried out the inspection:

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Requesting evidence from the provider.
  • A site visit.
  • Completing clinical searches on the practice’s patient records system in line with all data protection and information governance requirements.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.

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.
  • Information from the provider, patients, the public and other organisations.

The practice remains rated as Good overall.

We rated the practice as good for providing safe services because;

  • The provider had made improvements to the practice’s systems, practices and processes to help keep people safe and safeguarded from abuse.
  • The provider had taken action and made improvements to systems and processes to help maintain appropriate standards of cleanliness and hygiene.
  • Improvements had been made to the way risks to patients, staff and visitors were assessed, monitored and managed.
  • The provider had made improvements to the arrangements for managing medicines that helped keep patients safe.

Other findings:

  • The provider had revised practice systems to help ensure that all reviews of patients with long-term conditions continued to follow relevant best practice guidance.
  • Action taken by the provider had resulted in uptake of childhood immunisations improving to meet the 90% minimum in 4 out of 5 indicators and meet the World Health Organisation (WHO) minimum of 95% in the remaining indicator.
  • Ombudsban details were now being included in all replies to complaints.
  • The provider continued to deliver care and treatment in a way that was accessible to patients.

Whilst we found no breaches of regulations, the provider should:

  • Revise medicines management to help ensure action taken when the temperature of designated medicines refrigerators is recorded as being outside of acceptable limits (of between 2 and 8 degrees centigrade) is clearly recorded.
  • Continue with plans to carry out monthly searches of the practice computer system to help ensure all staff are complying with all relevant safety alerts.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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

Please refer to the detailed report and the evidence tables for further information.

20 May 2022

During an inspection looking at part of the service

This practice is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

The full comprehensive report can be found by selecting the ‘all reports’ link for Dr K Manivannan & Dr B Gurung on our website at www.cqc.org.uk.

Why we carried out this inspection:

We carried out an announced inspection at Dr K Manivannan & Dr B Gurung on 20 May 2022 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

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 in line with all data protection and information governance requirements.

This included:

  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider
  • Requesting evidence from the provider
  • A short site visit

Our judgement of the quality of care at this service is based 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.

Our findings:

We have rated this practice as Good overall.

  • Most of the practice’s systems, practices and processes kept people safe and safeguarded from abuse.
  • Staff had the information they needed to deliver safe care and treatment.
  • The practice learned and made improvements when things went wrong.
  • Patients’ needs were assessed, and care as well as treatment were delivered in line with current legislation, standards and evidence-based guidance.
  • Published results showed that performance for breast and bowel cancer screening was higher than local and England averages.
  • Staff had the skills, knowledge and experience to carry out their roles.
  • Staff treated patients with kindness, respect and compassion.
  • Feedback about the practice from the national GP patient survey published in July 2021 was positive with patient scores for all five indicators being higher than local and England averages.
  • Staff helped patients to be involved in decisions about their care and treatment.
  • People were able to access care and treatment in a timely way.
  • The practice involved the public, staff and external partners to help ensure they delivered high-quality and sustainable care.

However, we rated the practice as Requires Improvement for providing safe services because:

  • Improvements were required in the management of some risks to patients, staff and visitors from fire safety, infection prevention and control, and legionella.
  • The arrangements for managing medicines did not always keep people safe.

The areas where the provider must make improvements are:

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

The areas where the provider should make improvements are:

  • Consider revising practice systems so that they always alert staff to family and other household members of children on the risk register.
  • Continue with plans to clean cloth covered chairs in the practice.
  • Continue to ensure all Patient Group Directions are completed correctly to make certain they are valid for use by relevant staff.
  • Consider revising practice systems to ensure that all prescribing of high-risk medicines continues to follow relevant best practice guidance.
  • Continue to act on and learn from all safety alerts.
  • Consider revising practice systems to ensure that all reviews of patients with long-term conditions continue to follow relevant best practice guidance.
  • Continue with plans to improve uptake of childhood immunisations by relevant patients.
  • Continue with plans to include ombudsman details in all replies to complaints.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Please refer to the detailed report and the evidence tables for further information.

9 December 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr B Fernando and Dr K Manivannan on 9 December 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable, people whose circumstances may make them vulnerable. It required improvement for providing safe services.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed, with the exception of those relating to emergency situations.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • Data showed patient outcomes were average for the locality. Audits had been carried out, we saw evidence that audits were driving improvement in performance to improve patient outcomes.
  • 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 and how to complain was available and easy to understand.
  • Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for non-urgent appointments.

The areas where the provider must make improvements are:

  • Ensure risk assessments and required equipment is in place for dealing with medical emergencies.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice