We carried out an announced comprehensive inspection on 26 September to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The service is a private GP service providing care for patients in their own home, seven days a week. The service had been operating for 18 months and had approximately 300 patients. The service had also provided slimming advice and treatment. However, we were informed prior to the inspection, that uptake of this service had been low and had only two patients had used the service in the past month. On the day of the inspection, we were informed the slimming service had been withdrawn.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At BMP Medical Ltd, services are provided to patients under arrangements made by their employer with whom the servicer user holds a policy. These types of arrangements are exempt by law from CQC regulation. Therefore, at BMP Medical Ltd, we were only able to inspect the services which are not arranged for patients by their employers.

Our key findings were:

• Systems were in place to protect people from avoidable harm and abuse. When mistakes occurred, lessons were learned.
• There were some arrangements in place for the management of medicines but these required further development to reduce risks. For example, the service did not have a system to review medicine safety alerts or mechanisms to verify patient identity prior to issuing prescriptions.
• There was no system in place to ensure that equipment used by clinical staff had been appropriately calibrated and relied on clinicians to do this task themselves.
• The service had arrangements in place to respond to medical emergencies. There were protocols to check expiry dates of emergency medicines but there was no evidence that these were routinely followed. There was no risk assessment in place for what emergency medications were required.
• There was no monitoring of health and safety and fire safety for the premises to ensure the suitability for use. Prior to our inspection, patients had attended the premises for treatment. However, we were advised that this no longer happened and patients were seen in their own home.
• Staff were aware of current evidence based guidance. Staff received induction training about the service and policies. Staff did not receive their basic mandatory training or appraisals from the service, as they worked predominantly for the NHS and received their training from other GP practices. The service asked for evidence that staff training and revalidation was completed.
• Patient survey information reviewed indicated that patients were very satisfied with the service they received. Patients commented that staff were knowledgeable and professional and that they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• There was a clear leadership structure but risk management systems required improvement.
• The provider was aware of the duty of candour.

We identified regulations that were not being met and the provider must:

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

There were areas that the provider could make improvements and should:

• Review service policies and protocols to ensure they are service specific and adhered to.
• Review risk management activity with regards to the safety of the premises and equipment, and prescribing safety.
• Review how the service maintains oversight of training and appraisals for all staff.