We carried out an announced comprehensive inspection on 6 March 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; however, there were some areas where the provider should make improvements.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations; however, there were some areas where the provider should make improvements.

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; however, there were some areas where the provider should make improvements.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Medicaoptima Ltd provides a private general practice service, primarily to the local German-speaking population. The service is run by a single-handed GP, supported by a team of administrative staff. Other services are provided from the building, including consultations with a psychiatrist, psychologist, nutritionist and Chinese Medicine practitioner.

The 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.

During the inspection we spoke to four patients, all of whom were happy with the service the received from the practice. We also reviewed all of the 21 CQC comments cards which had been completed by patients prior to the inspection and all of these contained positive feedback about the standard of care provided.

Our key findings were:

• The practice had systems to manage risk so that safety incidents were less likely to happen; however, at the time of the inspection, in some areas these systems had not been formalised or risk-assessed; immediately following the inspection the practice provided evidence that a formal risk assessment in relation to Legionella and Infection Prevention and Control had been completed. When incidents did happen, the practice learned from them and improved their processes.
• The practice ensured that care and treatment was delivered according to evidence based guidelines. There was some evidence of formal structured reviews of the effectiveness and appropriateness of the care provided; however, this required some further development.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a focus on continuous learning and improvement.

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

• Review their current arrangements for checking the identity of patients and checking parental responsibility to ensure they are effective.
• Continue to embed their newly introduced risk assessment process for managing the risk of infection and Legionella.
• Review their current arrangements for sharing information with patients’ registered NHS GP to ensure that risks are mitigated.
• Review their arrangements for documenting action taken in response to safety and medicines alerts.
• Review their arrangements for monitoring and reviewing the quality of care provided.
• Review their policies and procedures to ensure they contain current, practice-specific information.