We carried out an announced comprehensive inspection on 1 August 2018 to ask the provider the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that the location was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

We carried out an announced comprehensive inspection of Japan Green Medical Centre Limited (the provider) on 1 August 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions, to confirm that legal requirements and regulations associated with the Health and Social Care Act 2008 were being met. We had previously inspected the service in May 2013, using our old methodology, when we found it was compliant with the regulations applicable at the time. The provider also operates another clinic in west London, which we inspected in November 2017.

During our visit we spoke with the location’s registered manager, who is a doctor registered with the General Medical Council, together with members of the nursing staff, healthcare assistants and administrative staff. 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.

Our key findings were:

• The provider had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the provider learned from them and improved.
• The provider reviewed the effectiveness and appropriateness of the care. 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.
• Patient feedback was consistently positive.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

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

• Review the recently completed legionella risk assessment and implement any management plan associated with it.
• Re-establish processes for seeking patient feedback.
• Ensure all governance policies are regularly reviewed and updated.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We were able to speak with two patients who attended the clinic on the day of our inspection. Both patients were very happy with the quality of care offered and told us staff treated them with dignity and respect. One person told us: "I am very happy with the clinic. I come here because of Japanese doctors and they know my needs." The other person told us: "I don't speak English very well so I like coming here. The doctor explains everything to me in Japanese and I don't need to feel nervous. They treat me well."

People experienced care, treatment and support that met their needs and protected their rights.

The equipment that people used was properly maintained to ensure it was safe and suitable for use.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We were able to speak with two patients who attended the clinic on the day of our inspection. Both patients were very satisfied with the quality of care offered and told us they were treated with dignity and respect. One person told us: 'I like coming here and I get to see a doctor who is able to speak Japanese and knows my needs.' The other person told us: 'the service is very good and staff are nice and friendly'.

As part of our visit we also looked through quality assurance questionnaires, which showed high levels of satisfaction with the services offered by the service.

We spoke to two people using the service about their experience. They were both happy with the service, in particular the fact that the service was tailored to Japanese people and there was enough time in the consultation with the doctor. Both people praised the way the doctor explained things.

To obtain a more general picture of people’s experience, we looked at the provider’s patient surveys which were very positive. In 2010, 68% described the service as ‘excellent’ and a further 29% as ‘good’ when asked about their overall satisfaction. A number of comments highlighted how worried people were about needing healthcare and how useful they found the service, for example: ‘I was very anxious as I was travelling but the kindness of the staff made me relieved.’