Dr Daniel Consulting Rooms

Updated 17 February 2023

Dr Daniel Consulting Rooms, also known as Foresight Medical Centre, is located at 99 Harley Street, London W1G 6AQ. The building entrance lobby is accessed via two steps from the pavement. Wheelchair access is via a ramp (patients are advised of this and a member of staff is available to assist patients). The service is easily accessible by public transport and is a short walk from Regents Park Station.

The female GP principal is also the service manager and does not currently employ any staff. The practice is open from 9am to 12noon Monday to Friday.

The practice offers consultations and treatment for adults 18 years and older. Services provided include management of long-term conditions; gynaecological assessment; ECG (Electrocardiogram); blood and other laboratory tests. Patients can be referred to other services for diagnostic imaging and specialist care. The provider is registered with the Care Quality Commission (CQC) for the regulated activities of Diagnostic & Screening Procedures, and Treatment of Disease Disorder or Injury.

How we inspected this service

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.

We carried out this inspection on 28 November 2022. The inspection was led by a CQC inspector who was accompanied by a GP specialist advisor. Before visiting, we looked at a range of information that we hold about the service. We reviewed the last inspection report from October 2021 and information submitted by the service. During our visit we interviewed the GP principal who was also the service manager and observed practice and reviewed documents.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 17 February 2023

This service is rated as Good overall.

(Previous inspection 11 October 2021 – Requires improvement)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at Dr Daniel Consulting Rooms to follow up on previous breaches of regulations. During this inspection we inspected five key questions, safe, effective, caring, responsive and well led.

CQC inspected the service in October 2021. We rated the service as requires improvement overall due to concerns with risks identified by building management not being monitored and staff not receiving training essential to their roles. The service was given requirement notices.

We checked these areas as part of this comprehensive inspection and found some improvements had been made whilst some concerns had not been addressed. The impact of our concerns is minor for patients using the service, in terms of the quality and safety of clinical care. The likelihood of this occurring in the future is low once it has been put right.

Dr Daniel Consulting Rooms, also known as Foresight Medical Centre, is an independent GP practice located in the London Borough of Westminster.

The provider Dr Alix Daniel is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• The service had succeeded in making a range of improvements. For example, by undertaking appropriate safeguarding training and implementing information security and an infection control policy.
• The provider had started to implement systems and processes in response to the findings of our last inspection. However, the governance arrangements in place were not effective, especially in relation to identifying, managing and mitigating risks. The provider had not checked that priority actions from the fire safety risk assessment were completed or ensured oversight of other risks relating to the building management.
• Records were written and managed in a way to keep people safe. Patient notes were easily accessible in an emergency and it was possible for the provider to share information with other services when there was an urgent need.
• There was limited evidence of overall quality improvement activity. However, individual patients were monitored to review the effectiveness and appropriateness of the care provided.

The areas where the provider must make improvements as they are in breach of regulations are:

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

Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Take action to ensure that a child safeguarding policy is available for staff to refer to in conjunction with the adult safeguarding policy.
• Take action to be assured that IPC measures are effective by documenting cleaning schedules and undertaking audit activity.
• Continue to develop quality improvement systems that monitor the positive impact on quality of care and patient outcomes.
• Review the process for sourcing patient feedback on the quality of clinical care received, to improve and develop the service.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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