We visited this service on 14 November 2013. We had concerns how this standard was managed. This was because checks to ensure the suitability of staff to work were not always undertaken. This potentially impacted on patients as they could not be sure staff were suitably assessed as being able to work within the practice.

We set a compliance action for the provider to improve practice. The provider sent us an action plan which outlined how they intended to become compliant.

We revisited the practice on the 17 February 2014 and saw thorough checks were now undertaken when recruiting staff. This ensured staff suitability to work.

We saw people's consent was obtained before treatment was provided. People were given information on their treatment options so they could make an informed decision around their care. One person told us "They advise me what needs to be done and check that I’m willing to proceed." Staff members were aware of the Mental Capacity Act (2005) and how this impacted on people's ability to consent to treatment.

We saw that people's medical histories were taken into account. New patients were required to fill in a medical history questionnaire and people's medical histories where reviewed regularly. One person told us "They check my medical history and I have to sign my form if there are any changes."

Staff members we spoke with demonstrated how to raise safeguarding concerns when providing care and treatment to patients. Staff had access to relevant policies and guidance around safeguarding. This demonstrated that people's safety and welfare was appropriately met.

Recruitment checks and procedures were not in line with legal guidelines. We saw not all staff had appropriate pre-employment checks. Patients could not be confident that they were being treated by staff who were assessed as experienced, qualified and through effective recruitment checks.