Archived: Dr Varendar Winayak and Partner Also known as Twickenham Park Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Varendar Winayak and Partner on 15 September 2016. The practice was rated as good overall. A breach of legal requirements was found relating to the Safe domain. After the comprehensive inspection, the practice submitted an action plan, outlining what they would do to meet the legal requirements in relation to the breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During the comprehensive inspection we found that the practice had failed to ensure that all significant events were fully recorded and that lessons were learned from incidents. We also identified areas where improvements should be made, which included reviewing how they identified patients with caring responsibilities, ensuring that details of verbal complaints were recorded, ensuring that audits were used to drive improvement, reviewing their buddy arrangement with a neighbouring practice to ensure that associated risks are identified and mitigated, ensuring that all staff knew how to use the defibrillator, ensuring that they had adequate security arrangements for the storage of prescription sheets and pads, and ensuring that uncollected prescription were reviewed.

We undertook this focussed desk-based inspection on 16 March 2017 to check that the practice had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr Varendar Winayak and Partner on our website at www.cqc.org.uk.

Following the focussed inspection, we found the practice to be good for providing safe services.

Our key findings were as follows:

• The practice had an effective system in place for reporting and recording significant events. Learning from significant events was shared with staff in order to make improvements to safety.
• Since the initial inspection, the practice had reviewed its protocol for recording details about patients with caring responsibilities and had identified various opportunities where staff could potentially identify whether a patient was a carer. As a result, the number of patients recorded as carers on their clinical system had increased from 35 patients (approximately 1%) to 441 patients (approximately 11%).
• The practice had an effective system for recording verbal complaints. We saw evidence that all staff were engaged in this process and that complaints were discussed in practice meetings in order that learning could be shared.
• The practice had a programme of audit in place. We saw evidence that this was used to identify areas for improvement and that the impact of changes made were analysed.
• The practice had a reciprocal buddy arrangement with a local small practice, who were available to provide clinical and leadership cover when the partners were absent (for example, during holidays). The practice performed background checks on staff providing cover and had taken all reasonable steps to ensure that they were appropriately trained.
• The practice had purchased a defibrillator following the initial inspection, and we saw evidence that all staff had been trained to use it.
• The practice had arrangements in place to ensure that blank prescription pads and sheets were stored securely, and we saw evidence that all staff had been made aware of these arrangements and their responsibilities in relation to them.
• The practice had a process in place to regularly review prescriptions which had not been collected, and patients were contacted by phone and text message to remind them to collect their prescriptions.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice