This inspection included checking that improvements had been made to the requirements relating to workers and assessing and monitoring the quality of service provision as the provider was non compliant following our inspection on 12 March 2013 in those areas. We found that the provider was now compliant.

The provider now had an effective recruitment and selection policy in place and carried out the relevant checks when they employed staff.

The provider had improved the systems in place to identify, monitor and manage risks to people who use, work in or visit the service. This was because they had improved records at the service to demonstrate learning from adverse events and audits and other information where they may not be compliant.

Patients who used the service understood the care and treatment choices available to them. Patient’s privacy, dignity and independence were respected. One patient said, "I’ve come for treatment today. They offered me a choice of appointments and booked me in straight away. They treat me as a patient, not a number. The staff are very professional and always listen.”

Patients experienced care, treatment and support that met their needs and protected their rights. All patients we spoke with spoke highly about the care, support and treatment they had been given by the practice. One person said, "they’re extremely helpful, charming and always have a chat with you. It’s an extremely good service. Everything’s explained.”

Patients we spoke with told us the practice was always clean and tidy.

The provider had not obtained all the required recruitment checks before staff commenced work.

Patients who used the service and their representatives were asked for their views about their care and treatment. However, there was no effective system to regularly identify, assess and manage the risks relating to the health, welfare and safety of patients and others who may be at risk from the carrying on of the regulated activity.