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Dr John Livingstone, London.

Dr John Livingstone in London is a Doctors/GP specialising in the provision of services relating to diagnostic and screening procedures, family planning services, maternity and midwifery services, services for everyone, surgical procedures and treatment of disease, disorder or injury. The last inspection date here was 1st May 2019

Dr John Livingstone is managed by Dr John Livingstone.

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Requires Improvement
Caring: Good
Responsive: Good
Well-Led: Requires Improvement
Overall:

Further Details:

Important Dates:

    Last Inspection 2019-05-01
    Last Published 2019-05-01

Local Authority:

    Greenwich

Link to this page:

    HTML   BBCode

Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

1st March 2019 - During a routine inspection pdf icon

We carried out an announced comprehensive inspection at Dr John Livingstone on 1 March 2019 as part of our inspection programme.

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, requires improvement for providing safe, effective and well led services and good for providing caring and responsive services.

Due to underlying issues with the provision of effective services, this means that the practice is rated as requires improvement for providing effective and responsive care to older people, people with long term conditions, families, children and young people, working age people, those whose circumstances may make them vulnerable and those experiencing poor mental health.

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

  • The practice did not have effective systems in place for the safe management of health and safety including an active process to identify and control areas of risk.
  • Some staff records that we saw did not contain evidence of staff immunisations in line with Public Health England guidance.
  • Not all staff had up to date safeguarding training appropriate to their roles.
  • We saw no evidence of staff completing fire training.
  • We did not see evidence of an infection control audit being completed.
  • We did not see any evidence of recommendations of a legionella risk assessment that had been completed in 2012 being carried out since March 2016.
  • Staff had not been trained in the identification and management if sepsis.
  • The outcomes of safety alerts required clear evidence of the follow-up actions taken to keep patients safe.
  • We saw no evidence of staff being trained as chaperones.
  • We could not find any evidence of the electrical system having been inspected since 2012.
  • The fire alarm was last serviced in September 2017.
  • The practice didn’t have some recommended medicines, or risk assessments to justify why they were not present.
  • We found glyceryl trinitrate (GTN), a spray used to relieve angina (chest pain) which had expired in June 2015.

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

  • The practice was below the local and national averages in most areas related to the management of diabetes and other long-term conditions.
  • We saw two audits that had been completed but these were not two cycle audits but rather patient searches over a three-year period.

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

  • The practice’s governance arrangements required improvement to ensure that there was clarity in terms of responsibilities for site management, with the provider maintaining evidence to demonstrate their ongoing compliance with regulations.
  • The practice did not have regular meetings where learning and dissemination from significant events could occur.
  • Those meetings which did take place were not minuted.
  • We were told of two audits being completed but these were not two cycle audits and did not show any evidence of quality improvement.
  • Many of the policies were out of date or contained insufficient or inaccurate detail.

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

  • Patients received effective care and treatment that met their needs. The practice could demonstrate good patient outcomes were delivered.
  • Staff treated patients with kindness and respect and involved them in decisions about their care. The practice ethos was to provide an accessible and approachable patient-orientated service.
  • Patients could access care and treatment in a timely way. The practice organised and delivered services to meet their patients’ needs.

The areas where the provider must make improvements are:

  • 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).
  • 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).

In addition, the provider should:

  • Review and action the needs of those patients with long term conditions, so as to improve their clinical outcomes.
  • Ensure that carers are correctly identified and coded so they can be supported effectively and adequately signposted.
  • Continue to collate the evidence of staff immunisations in line with Public Health England guidance.
  • Review and update training for staff which is relevant to their role.

Please refer to the detailed report and the evidence tables for further information.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

13th January 2016 - During a routine inspection pdf icon

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr John Livingstone - Eltham Park Surgery on 13 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was a transparent and proactive approach to safety and a system was in place for reporting and recording significant events.
  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care delivered in line with current best practice guidance.

  • Staff received ongoing training and development to ensure they had the skills, knowledge and experience to deliver effective care and treatment with the exception of chaperone training for non-clinical staff.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that 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.
  • The practice had a clear vision to deliver a high quality and compassionate service which was responsive to patients needs and promoted the best possible outcomes for patients.
  • 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 and complied with the requirements of the Duty of Candour.

There were also areas of practice where the provider should make improvements:

  • The provider should ensure that all staff who might be called upon to act as chaperones have the appropriate training.

  • The provider should formalise the procedure for sharing learning from incidents, complaints, safety alerts and external meetings by documenting all minutes of meetings where learning is shared .

  • The provider should store blank prescription pads in a locked cupboard when not in use and records should be kept of batch numbers of blank electronic prescriptions placed in individual printers.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

 

 

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