We carried out an announced comprehensive inspection on 8 June 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 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.

Dr Kenric Li provides a primary care service from a clinic in Kensington. The practice holds a list of registered patients who can book appointments with a GP or nurse with onward referral to diagnostic and specialist services as appropriate. The service treats children and adults.

We received 53 completed comment cards completed by patients in the days leading up to the inspection. These were wholly positive and described the service as accessible; the quality of care as excellent; and the staff as kind, caring and professional.

Dr Kenric Li is registered as an individual provider. The service is registered to provide the regulated activities of: diagnostic and screening services and treatment for disease, disorder or injury.

Our key findings were:

• Systems were in place to protect people from avoidable harm and abuse.
• When mistakes occurred lessons were learned and action was taken to minimise the potential for reoccurrence. Staff understood their responsibilities to be open with patients.
• Clinical staff were aware of current evidence based guidance.
• Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
• Patient feedback indicated that patients were happy with the service they received.
• Information about services and how to complain was available.
• There was clear leadership and staff felt supported. The practice team worked well together.
• There was a clear vision to provide a family focused and personalised service.
• The service had some systems in place to monitor and improve the quality of service provision although systems were not always operating as intended.

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

• Review its policies and protocols to assure itself these are operating as intended, for example that mandatory training is completed when due. It should also review for example, the introduction of periodic audit of infection prevention and control in line with national guidelines.
• Review whether clinical staff should undertake training on their responsibilities under the Mental Capacity Act 2005 if they have not already done so.
• Review the scope to improve its quality improvement activity including clinical audit.
• Review the scope to document meetings and share these notes with the staff team for future reference and to ensure any agreed actions are followed up.

We did not speak to people using the service during our visit as there were no appointments scheduled. We reviewed feedback questionnaires and found that people were positive about the care they received and the service facilities. One person wrote "Staff are totally professional, discreet and have a wonderful caring attitude." Another person commented that "I look forward to my visits as the practice is always so welcoming." We saw evidence that the service had resuscitation equipment and that the Doctor had received up to date training to deal with emergency situations. Cleanliness was maintained and infection control practices were appropriate to prevent the spread of infection.

Medicines were stored appropriately and vaccine stock records were accurate. However, some emergency medicines for the management of serious drug allergy had expired and the stock records for this therapy had not been reviewed. This meant that people were not adequately protected from the risk of receiving expired medicines in the event of an emergency.

We found that service quality was routinely monitored through audit, reflection and feedback. We saw evidence that the Doctor made improvements to the service by purchasing new equipment and changing care practices to increase compliance with national clinical guidelines. We looked at the training records for the Doctor and found that recent professional development was appropriate for the role of a registered General Practitioner (GP).