We carried out an announced comprehensive inspection on 11 May 2018 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 not 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 not 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.

Dr Guy O’Keefe’s Practice provides a private general practice service to patients at 26 Eaton Terrace in the borough of Westminster in London.

Prior to our inspection, patients completed CQC comment cards telling us about their experiences of using the service. Thirty-four people provided wholly positive feedback about the service. Dr O’Keeffe was described as caring, attentive and efficient.

Our key findings were:

• The service had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The service had carried out a safety risk assessment of the premises and equipment; however, there was minimal evidence that risks were fully assessed and well-managed; a number of health and safety and premises checks had not been undertaken and equipment had not been calibrated.
• The premises were clean and well maintained, however no infection control audits or infection control training had been completed.
• Procedures for managing medical emergencies including access to emergency medicines and equipment were safe.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients.
• There was a system for recording and acting on incidents, adverse events and safety alerts. The provider shared safety alerts with staff effectively.
• There was limited evidence of systems to support good governance and management.
• Staff felt involved and supported and worked well as a team.
• Patient feedback for the services offered was consistently positive.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.

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

• Establish a system to provide appropriate support and signposting for patients with a caring responsibility

We were not able to speak with any people using this service as no one had an appointment during our visit. As a single handed doctor Dr O’Keeffe had arranged this so that he had time to discuss the service with us. We saw the patient feedback forms analysed in June 2012. These showed a high level of patient satisfaction.