A South London GP surgery is facing closure after inspectors were told its two GP partners and a manager were not speaking to each other. Staff were also seen "audibly sighing in a frustrated manner" and walking away from a patient who was speaking at reception.

The Village Surgery in Kingston was branded "inadequate" – the worst possible rating – by the Care Quality Commission (CQC) in a damning report released this month. The practice, at 157 High Street in New Malden, was already in special measures after being rated "inadequate" following an inspection in September 2021. The practice has around 5,600 patients.

When inspectors arrived for the unannounced inspection on February 25, the trainee practice manager was not sure whether they were responsible for managing the practice that day. Inspectors found the "same problems" in all four clinical treatment rooms, including expired clinical items such as needles, wipes, testing kits and bandages. Some of the items had expired in 2017. 

Inspectors found clutter on all the surfaces, overflowing clinical waste bins and cracked walls with peeling paint. They were told one of the rooms was not being used for clinical work because it had a large hole in the ceiling. A notebook also revealed that the front door of the practice had been left unlocked three times in the last six months.

There were hundreds of overdue medication reviews and not all emergency medicines were stocked, according to the report. The surgery is said to have put some patients at risk of harm, including 21 patients with heart failure who were overdue a review, 91 patients with hypertension overdue a blood pressure check and 266 patients overdue for cervical screening.

Staff were seen telling a Korean patient over the phone that they had to get an English speaker to be able to communicate with the practice. The report says: "It is well known that New Malden has a large Korean population. The practice is aware of this as the partners and practice manager have mentioned it. No reference was made to the interpretation services available or supposedly used by the practice to enable patients who do not speak English to communicate."

Staff said the management team was "difficult" to communicate with, including shouting, ignoring or arguing with staff and sometimes clinicians. Inspectors heard that meeting minutes were "edited in order to cover up concerns regarding clinicians". 

The report also raised concerns about a breakdown in communication between the management team which had created a "tense atmosphere". It says: "The practice manager and the two GP partners (leads) had stopped meeting to discuss quality and sustainability for over a year. All three of them told us that they were not speaking to one another and every staff member we spoke with was also aware of the divide in leadership."

Inspectors said both partners were now attending clinical meetings. The report adds: "There was a new practice manager training at the time of this inspection, but they were not yet ready to take on full responsibility for managing the practice."

Inspectors said "insufficient improvements" had been made overall since the September inspection. If there is no improvement in six months, the CQC could force the practice to close by cancelling its registration.

The watchdog said: "Where necessary, another inspection will be conducted within six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider's registration to remove this location or cancel the provider's registration." 

A spokesperson for NHS South West London Clinical Commissioning Group said: "It's extremely important that people in Kingston receive high quality GP services. Should the practice's registration be removed, the CCG has plans in place to ensure all registered patients would continue to have access to GP services." The Village Surgery has been contacted for comment.