We were unable to speak to people during the inspection however we have used their feedback and comments from the provider's most recent satisfaction survey. People rated the care and treatment highly and their comments included "First class doctor. The best I have experienced" and "I go out of my way to see this doctor".

We found people’s needs were assessed and care and treatment was planned and delivered in line with their individual wishes. Consultations were held in private and the findings were recorded at the time in people's medical records.

There were arrangements in place to deal with foreseeable emergencies and staff were trained to deal with medical emergencies and in basic life support. The provider had an effective system to regularly assess and monitor the quality of service that people received.

In the case of this location it was impracticable to undertake a visit when patients were on site, so we did not speak to people who use services.

We carried out an announced comprehensive inspection on 14 November 2017 and 6 December 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We carried out two announced visits to this location as part of this inspection due to an unexpected absence from the inspection team on the first visit. We carried out a second visit in order to complete the inspection. 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.

Our findings were:

Are services safe?

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

Are services effective?

We found that this service was not providing effective services 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 services in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led services in accordance with the relevant regulations.

Background

Guy Barrington Staight - Pelham Street (also known as The Staight Practice) is a private doctor’s practice situated close to South Kensington tube station. The practice premises are located within a building that is primarily made up of residential apartments. The practice premises are located below street level and accessible via stairs only. The practice offers general medical services to adults and children, usually between 8.30am and 6.30pm on Mondays to Fridays. There are three general practitioners, two are part-time. One of the three practitioners is female. The GPs are supported by a technician who is a former nurse and a team of three administrators and receptionist. There are other services provided from the location, but these are out of scope for CQC registration including occupational health services provided to employees under arrangements made by their employer. Consultations and treatments are also provided by a physiotherapist, clinical psychologist, a nutritionist and podiatrist, all of which are exempt from CQC regulation.

The lead GP is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Forty three people provided feedback about the service by completing comments cards. The feedback was entirely positive about the practice, its staff and the care and treatment received. We also spoke with six patients during our inspection, who all also gave entirely positive feedback about the practice.

Our key findings were:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients’ feedback indicated they were satisfied with care and treatment, facilities and staff at the practice.
• The practice ensured that care and treatment information was appropriately shared when people moved between services. When patient consent, their NHS GP if they had one was kept informed of the care and treatment they received.
• There was a strong focus on continuous learning and improvement among the clinical staff.

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

• Ensure care and treatment must be provided in a safe way for service users
• Ensure they have suitable systems and processes in place that assess, monitor and mitigate any risks relating the health, safety and welfare of people using services and others
• Ensure staff receive the support, training, professional development, supervision and appraisals that are necessary for them to carry out their role and responsibilities.

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:

• Review their arrangements to meet the needs of patients whose first language was not English, make clear the physical access restrictions on their website and consider how to make improvements to support the service accessibility to patients with sensory deprivation. The provider should consider a Disability Access Assessment.