The Care Quality Commission
  • Doctor
  • GP practice

Archived: The Randolph Surgery

Overall: Requires improvement read more about inspection ratings

235a Elgin Avenue, London, W9 1NH (020) 7266 2621

Provided and run by:
The Randolph Surgery

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

All Inspections

12 July 2018

During a routine inspection

This practice is rated as requires improvement overall.

(At the previous inspection in December 2014 the practice was rated as good overall).

The key questions are rated as:

Are services safe? - Good

Are services effective? - Requires improvement

Are services caring? - Requires improvement

Are services responsive? - Requires improvement

Are services well-led? - Requires improvement

We carried out an announced comprehensive inspection at The Randolph Surgery on 12 July 2018. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether The Randolph Surgery was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

  • There was a lack of local clinical leadership and governance.
  • Risks to patients were assessed and well managed in some areas, with the exception of those relating to calibration of medical equipment, childhood immunisations and management of blank prescription forms.
  • There was limited evidence of quality improvement activity in some areas to review the effectiveness and appropriateness of the care provided.
  • According to unverified and unpublished data there was a significant reduction in the Quality Outcomes Framework (QOF) results for the year 2017/18 compared to the previously published QOF results for 2016/17.
  • The practice’s uptake of the national screening programme for breast cancer screening and childhood immunisations rates were below the national averages.
  • There were ineffective arrangements in place for planning and monitoring the number of staff needed to meet patients’ needs.
  • Patients feedback highlighted concerns about the appointment booking system, availability of appointments with the GPs and the continuity of care.
  • Feedback suggested that patients felt they were not always involved in making decisions about their care and treatment and they did not have sufficient time during consultations to make an informed decision about the choice of treatment available to them.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff had received up to date training relevant to their role. Staff appraisals had been completed in a timely manner.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about services and how to complain were available and easy to understand.
  • The practice was aware of and complied with the requirements of the Duty of Candour.
  • Staff we spoke with informed us the management was approachable but they reported lack of responsiveness and support from the head office, and they did not have confidence that their concerns would be addressed in a timely manner.

The areas where the provider must make improvements are:

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

The areas where the provider should make improvements are:

  • Review the system in place to improve the management of blank prescription forms, to ensure this is in accordance with national guidance.
  • Review and improve the systems in place to effectively monitor care plans and health checks for patients with learning disabilities and patients experiencing poor mental health.
  • Review the system in place to promote the benefits of childhood immunisation and breast cancer screening in order to increase patient uptake.
  • Ensure information about a translation service is displayed in the reception area informing patients this service is available. Ensure information posters and leaflets are available in multiple languages.
  • Ensure written information is available for carers to enable them to access the support available via the external agencies.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

03/12/2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Randolph Surgery on3 December 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health.

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.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • 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.
  • Patients said they found it easy to make an appointment with a named GP and that 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.

We saw areas of outstanding practice:

  • The practice had set up a monthly paediatric clinic attended by a hospital paediatric registrar with support from a paediatric consultant and two of the practice GPs on a rota basis, to meet the needs of families with young children.
  • The practice had supported patients living in two local hostels waiting re-housing who had complex medical needs. The practice routinely called these patients to remind them to attend booked appointments and there was an agreement with the hostel staff to support attendance in order to minimise missed appointments and ensure health care could be offered.

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

Importantly the provider should;

  • Implement a protocol for the management, testing and investigation of legionella (a bacterium which can contaminate water systems in buildings).
  • Ensure staff who may be called upon to act as a chaperone have received relevant training.
  • Ensure regular calibration checks of medical equipment are carried out, for example the spirometer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice