The Care Quality Commission
  • Doctor
  • Independent doctor

Dr Daniel Consulting Rooms

Overall: Good read more about inspection ratings

99 Harley Street, London, W1G 6AQ (020) 7935 7501

Provided and run by:
Alix Daniel

All Inspections

28 November 2022

During a routine inspection

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

11 October 2021

During an inspection looking at part of the service


This service is rated as Requires improvement overall. (Previous inspection February 2020 – Requires improvement)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

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

CQC inspected the service in February 2020. We rated the service as requires improvement overall due to concerns with risk identified by building management not being monitored, a lack of continuous audit activity to demonstrate positive clinical improvements to patients and staff not receiving formal training. The service was given requirement notices.

We checked these areas as part of this focused inspection and found some improvements had been made whilst others remained unresolved. 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 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:

  • Not all staff had received mandatory training relevant to their role. The lead GP did not have the appropriate level of safeguarding training for vulnerable adults and children.
  • The provider did not have a defined set of mandatory training that staff needed to complete to carry out their role effectively.
  • The governance systems in place were not always effective in overseeing risk.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients could access care and treatment from the service within an appropriate timescale for their needs.
  • Staff said that they felt happy to raise concerns or issues to the provider.

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.

  • Ensure persons employed in the provision of the regulated activity receive the

Appropriate support, training and appraisal necessary to enable them to carry out the duties.

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

The areas where the provider should make improvements are:

  • Improve service policies to ensure they are service specific.
  • Continue to monitor and review quality improvement for patients.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care

19 Feb 2020

During a routine inspection

This service is rated as Requires improvement overall. (Previous inspection 22 January 2019 was not rated)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

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 as part of our inspection programme and to follow up on breaches of regulations from a previous inspection on 22 January 2019. We asked the provider to make improvements regarding not meeting the regulations for providing safe, effective and well-led care. We checked these areas as part of this comprehensive inspection and found some improvements had been made whilst others remained unresolved. 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. We have told the provider to take action (see full details of this action in the Requirement Notices at the end of this report).

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

Fifteen people provided feedback about the service. All feedback we received was positive about the service.

Our key findings were:

  • Not all staff had received mandatory training relevant to their role. The GP did not have the appropriate level of safeguarding training for vulnerable adults and children.
  • The provider did not have a defined set of mandatory training that staff needed to complete to carry out their role effectively.
  • There governance systems in place were not always effective in overseeing risk.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients could access care and treatment from the service within an appropriate timescale for their needs.
  • Staff said that they felt happy to raise concerns or issues to the provider.

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.
  • Ensure persons employed in the provision of the regulated activity receive the appropriate training necessary to enable them to carry out the duties.

You can see full details of the regulations not being met at the end of this report

The areas where the provider should make improvements are:

  • Review service policies to ensure they are service specific.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

22 January 2019

During a routine inspection

We carried out an announced comprehensive inspection on 14 February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led? At the inspection we found the provider was not meeting the regulations for providing safe, effective and well-led care. The full comprehensive report on the February 2018 inspection can be found by selecting the ‘all reports’ link for Dr Daniel Consulting Rooms on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 22 January 2019 to confirm that the practice had taken action to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 14 February 2018. This report covers our findings in relation to those requirements.

At this inspection we found the provider had not made all the necessary improvements.

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

CQC inspected the service on 14 February 2018 and asked the provider to make improvements regarding safe care and treatment, and good governance. We checked these areas as part of this comprehensive inspection and found some issues had been resolved whilst others remained outstanding.

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

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.

Eleven people provided feedback about the service. All feedback we received was positive about the service.

Our key findings were:

  • Some systems and processes were in place to keep patients safe. However, we identified shortfalls in relation to the management of infection control.
  • Clinical audit activity had been initiated.
  • Staff had received annual appraisals. However, the service was unable to provide documentary evidence to demonstrate that all staff had received formal training relevant to their role.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Information about services and how to complain was available.
  • There was a lack of good governance around establishing key policies, staff training and seeking feedback from people using the service.

We identified regulations that were not being met and the provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

  • Review the safeguarding and chaperone policies to ensure they have sufficient and up to date information.
  • Review the system in place to ensure the accuracy of fridge temperatures and establish local protocols for maintaining the cold chain.
  • Review the monitoring system to ensure that regular safety checks have been undertaken by the building’s management.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

14 February 2018

During a routine inspection

We carried out an announced comprehensive inspection on 14 February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

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

The GP principal 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.

Nineteen people provided feedback about the service. All feedback we received was positive about the staff and service offered by the practice.

Our key findings were:

  • There were systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice delivered care and treatment according to evidence-based guidelines. However, there was no recent clinical audit to demonstrate the practice reviewed the effectiveness and appropriateness of the care it provided.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients reported that they were able to access care when they needed it.
  • The practice had not determined what mandatory and additional training staff needed to meet the needs of their patients.
  • The practice had not established some policies, procedures and activities to ensure safety and support good governance. For example, in relation to safeguarding; infection prevention and control; health and safety; and significant events or incidents.

We identified regulations that were not being met and the provider must:

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

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

  • Review the practice’s arrangements for chaperoning.
  • Review the system in place to ensure the accuracy of fridge temperatures.
  • Review patient access to interpreting services.

12 February 2013

During a routine inspection

People who had used the service told us that they were given information about their care and treatment before they underwent procedures. They said that staff were "very professional", "welcoming" and "very attentive".

People who had used the service described it as "very good". Appropriate medical checks were undertaken before people received treatment. We also looked at feedback questionnaires that had been completed in the last twelve months. Letters of thanks that had been sent to Dr Alix Daniel informed how patients were happy with the service. Overall, people were happy with the care and treatment received.

People who use the service were given sufficient information and were involved in making decisions about their care. People who use the service reported Dr Alix Daniel had understood their problem and that they understood their proposed treatment. People had described Dr Alix Daniel 'knowledgeable and reassuring". A medical history was taken for each person and there were procedures in place to deal with emergencies.

There was a safeguarding policy in place for protecting vulnerable adults, staff were able to describe what action they would take.

Staff received adequate training and supervision. There was a procedure in place for them to undergo annual appraisals.

The service conducted audits to monitor the quality of the service it was providing. Regular patient feedback questionnaires were completed.