We undertook a comprehensive inspection of this location on 19 September 2016 when the service was provided by Dr Thomas Barnwell and we found the practice to be inadequate and it was placed in special measures for a period of six months. The inspection report can be found by selecting the ‘all reports’ link for Dr Thomas Barnwell on our website at .

The location, now known as Little Venice Medical Centre, was taken over by the Wellington Medical Centre partnership in December 2016. We carried out an announced comprehensive inspection at the location on 11 January 2018 when the overall rating for the practice was Good with Requires Improvement for safe service. The full comprehensive report on the 11 January 2018 inspection can be found by selecting the ‘all reports’ link for Little Venice Medical Centre on our website at www.cqc.org.uk.

This inspection, on 13 December 2018, was an announced comprehensive inspection to confirm that the practice had carried out their plan to meet the requirements that we identified in our previous inspection on 11 January 2018.

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 good overall and good for all population groups.

We found that:

• The practice had been proactive and addressed the findings of our previous inspection in relation to cleanliness and infection prevention and control.
• 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 organised and delivered services to meet patients’ needs.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

However, the provider should:

• Continue to address the outstanding premises issue with the landlord in relation to the availability of hot water throughout the premises.
• Carry out a risk assessment and consider emergency medicines taken on home visits.
• Review the scope and consistency of documenting incidents to enable outcomes and learning to be shared within the practice.
• Review the process to document all patient safety alerts received and action taken in response to these.
• Continue with efforts to improve the uptake of child immunisations for children aged two and cervical screening.
• Continue to develop and encourage patients to join the patient participation group.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Little Venice Medical Centre on 1 December 2015 when the service was provided by Dr Thomas Barnwell. The overall rating for the practice was requires improvement. We undertook a follow-up announced comprehensive inspection on 19 September 2016 to consider if sufficient improvements had been made. At that inspection we found the practice to be inadequate and it was placed in special measures for a period of six months. The full comprehensive report on the 1 December 2015 and 19 September 2016 inspections can be found by selecting the ‘all reports’ link for Dr Thomas Barnwell on our website at www.cqc.org.uk.

The location was taken over by the Wellington Medical Centre partnership in December 2016. This inspection was an announced comprehensive inspection carried out on 11 January 2018 to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is now rated as Good.

The key questions are rated as:

Are services safe? – Requires Improvement

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

Our key findings were as follows:

• Since our previous inspection, the location had been taken over by another provider. They had worked with stakeholders to address the issues identified at our previous inspection and made considerable improvements in respect of safeguarding, staff recruitment, medicine management and recording of significant events However, on the day of the inspection we found some additional issues relating to cleanliness and infection prevention and control.

• The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

• The practice had a comprehensive programme of quality improvement activity, including clinical audit.

• Data showed patient outcomes for those with long-term conditions had improved since our previous inspection.

• Staff had the skills, knowledge and experience to carry out their roles.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Results of the national GP patient survey, comments cards we received and patients we spoke with showed patients felt they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• The partnership had redefined its organisation structure, recruited essential personnel and assigned leads for key areas. It demonstrated that it had engaged with its commissioners and stakeholders to improve governance and bring about improvements to patient outcomes.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

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

In addition the provider should:

• Display medical gas warning signage on the door where oxygen is situated.

• Continue to monitor and improve uptake of the cervical screening programme and childhood immunisation programme.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice