The Care Quality Commission
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  • GP practice

Park Royal Medical Practice

Overall: Requires improvement read more about inspection ratings

Central Middlesex Hospital, Ground Floor, Acton Lane, London, NW10 7NS (020) 8961 1183

Provided and run by:
Harness Care Ltd

All Inspections

07 October 2021

During a routine inspection

We carried out an announced inspection at Park Royal Medical Practice on 7 October 2021. Overall, the practice is rated as requires improvement.

Safe - Requires improvement.

Effective - Good

Caring - Good

Responsive - Good

Well-led - Requires improvement.

Following our previous inspection on 30 April 2019, the practice was rated requires improvement overall and for the key questions safe, effective and well-led but good for providing caring and responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Park Royal Medical Practice on our website at www.cqc.org.uk.

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on breaches of regulation and areas of concern identified at our previous inspection. We looked at all five key questions.

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 with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

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.

We have rated this practice as Requires Improvement overall.

We found that:

  • The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse.
  • The practice had systems to manage risk so that safety incidents were less likely to happen. However, the systems for the appropriate and safe use of medicines were not always effective and required improvement.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care. The practice had attempted to address areas of low satisfaction by offering staff training.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. The practice premises had been used as a vaccination centre for the locality since December 2020.
  • The practice had identified telephone access as an area of low patient satisfaction and had made improvements so that patients could access care and treatment in a timely way.
  • The practice was under new management since the last inspection in 2019. Leaders had a realistic strategy to achieve most key priorities. However, there were not always clear and effective processes for managing risks.

We found a breach of regulations. The provider must:

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

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

In addition to the above, the practice should:

  • Continue to review patient and staff feedback and engage with the PPG in relation to access and customer service at reception.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

30 April 2019

During a routine inspection

We carried out an announced comprehensive inspection at Park Royal Medical Practice on 30 April 2019.

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

We have rated this practice as requires improvement overall.

We rated the practice as requires improvement for providing safe services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • The practice had limited safeguarding systems in place to ensure that children and vulnerable adults are reviewed regularly.
  • The practice did not have appropriate systems in place for the safe management of test results.
  • The practice did not have appropriate systems in place for the safe management of medicines including controlled drugs.
  • The practice was unable to demonstrate they had audited all prescribers within the practice.

We rated the practice as requires improvement for providing effective services because:

  • There was limited monitoring of the outcomes of care and treatment.
  • The practice was unable to demonstrate that staff had the skills, knowledge and experience to carry out their roles.
  • Patient outcomes were hard to identify as limited clinical audits had been carried out to improve the quality of care. There was limited evidence that the practice was comparing its performance to others; either locally or nationally.
  • Some performance data was below local and national averages.

We rated the practice as requires improvement for providing well-led services because:

  • While the practice had a clear vision, that vision was not supported by a credible strategy.
  • The practice culture did not effectively support high quality sustainable care.
  • The overall governance arrangements were ineffective.
  • The practice did not have formal succession plans in place for when senior members of staff plan to retire.
  • The practice did not have clear and effective processes for managing risks, issues and performance.
  • The practice did not always act on appropriate and accurate information.

These areas affected all population groups so we rated all population groups as requires improvement .

We rated the practice as good for providing caring and responsive services because:

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • 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:

  • Improve the identification of carers to enable this group of patients to access the care and support they need.
  • Ensure that information regarding interpreter services, for patients whose first language is not English, is displayed prominently.
  • Ensure that all staff including practice nurses have annual appraisals.
  • Ensure information regarding how to make a complaint is easily accessible for patients.
  • Ensure practice policies are reviewed and updated regularly.
  • Ensure non-clinical staff undertake basic life support training regularly.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care