Dr Rachael Garner

Updated 4 April 2018

Dr Rachael Garner (Notting Hill Medical Centre) operates from a purpose-built property at 14 Codrington Mews, London W11 2EH. The property is shared with another GP practice. The practice has access to six consultation rooms on the ground floor.

The practice provides NHS primary care services to approximately 3,000 patients and operates under a General Medical Services (GMS) contract (GMS is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract). The practice is part of NHS West London Clinical Commissioning Group (CCG).

The practice is registered as an individual with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder or injury, maternity and midwifery services and surgical procedures.

The practice staff comprises of one female principal GP, two female and one male salaried GP (totalling 15 sessions per week), a nurse prescriber (32 hours per week), a part-time healthcare assistant and phlebotomist, a full-time practice manager and three receptionists. In addition, there is a case manager and health and social care assistant attached to the practice four days per week as part of the locally funded My Care, My Way initiative to manage patients aged 65 and over who had been identified by the practice using the Frailty Index (method to identify and predict adverse outcomes for older patients in primary care).

The practice is a GP training practice with the St Mary’s GP Speciality Training Scheme. At the time of our inspection there was a doctor in the final year of the speciality training (ST3) and a foundation year two (FY2) doctor on attachment with the practice.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are available on Monday and Thursday from 6.30pm to 8.30pm and Wednesday from 6.30pm to 7.30pm. On-line services, which include appointment booking and cancellation, updating personal information and repeat prescriptions can be accessed from the practice website www.nottinghillgp.co.uk.

Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. People living in more deprived areas tend to have greater need for health services.

Updated 4 April 2018

We carried out an announced comprehensive inspection at Dr Rachael Garner (Notting Hill Medical Centre) on 4 August 2015. The overall rating for the practice was good with requires improvement in providing safe services. The full comprehensive report on the 4 August 2015 inspection can be found by selecting the ‘all reports’ link for Dr Rachael Garner on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 22 February 2018 to confirm that the practice had carried out their plan to meet the requirements that we identified in our previous inspection on 4 August 2015. This report covers our findings in relation to those requirements and any improvements made since our last inspection.

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? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

At this inspection we found:

• The practice had addressed the findings of our previous inspection in respect of actioning the findings of a Legionella risk assessment and the safe storage and usage of liquid nitrogen.
• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. The practice had clear 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Results from the national GP patient survey showed patients rated the practice comparable with others for aspects of caring. Patients told us they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• The practice reviewed the needs of its local population and engaged in local health initiatives to improve patient outcomes.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review the NICE Guidelines NG51: Sepsis Recognition, Diagnosis and Early Management and consider if the practice can appropriately assess all patients, including children, with suspected sepsis.
• Review the fire evacuation procedure.
• Review the requirements of the Accessible Information Standard.
• Continue to monitor satisfaction feedback with respect to how patients access care and treatment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 4 April 2018

Updated 4 April 2018

Updated 4 April 2018

Updated 4 April 2018

Updated 4 April 2018

Updated 4 April 2018