We carried out an announced comprehensive inspection on 22 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 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.

Pharmacentre Limited is a high street pharmacy with a medical clinic for private GP consultations.

The service has a 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.

We received 11 completed Care Quality Commission comment cards all of which were very positive about the staff at the practice and the services received. We did not speak with patients directly at the inspection.

Our key findings were:

• There were no effective systems for complying with national patient safety alerts.
• Systems and processes were in place to keep people safe. However, these systems were not operated effectively to ensure care and treatment to patients was provided in a safe way, particularly given the patient group served.
• The provider did not have effective systems to minimise risks to patient safety, including arrangements for identifying, recording and managing risks and issues, ensuring on-going care and implementing mitigating actions.
• There were no effective systems for safeguarding of vulnerable adults, including gaps in training in this area and the absence of a safeguarding of vulnerable adults policy.
• The provider could not demonstrate that care was delivered consistently in line with current evidence based guidance.
• Clinical staff maintained continuing professional development but the provider could not demonstrate in all cases that they had received up to date training to keep patients safe.
• There was ineffective leadership. The provider could not assure us that the registered manager had the skills, knowledge and experience to run the service to ensure patients received safe and effective care.
• There were no effective governance arrangements in place. We were told policies and procedures were regularly reviewed but they had not been updated to take account of changes in inspection legislation.
• The provider was not aware of, and did not have systems in place to ensure compliance with, the requirements of the duty of candour.

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

• Ensure that the registered manager is a fit and proper person to carry on regulated activities through a criminal records check.
• Ensure care and treatment is provided in a safe way to patients.
• Introduce 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:

• Review the arrangements requiring patients to provide identification when registering with the service to ensure verification checks are recorded.
• Review the system for communicating blood test results to patients to ensure they are communicated in a timely way.
• Review the internal appraisal process to consider the inclusion of learning and development goals and a review of clinical performance.
• Review the arrangements for communicating with patients in different languages to provide access to interpretation services if needed.
• Review the practice’s aims and objectives with a view to developing a clear vision and set of values for the service including a strategy and supporting business plans to deliver them.

It was not possible to speak with people who use the service. The clinic is a walk-in clinic and no one requested an appointment during our visit.

We reviewed a patient feedback survey report which was written in January 2011. This indicated that overall people were happy with the treatment provided.

On this occasion we did not see or speak to any people that used the service. We inspected the clinic to check the cleanliness of the room.

We did not have the opportunity to speak to people who use services on this occasion. The clinic is a walk-in clinic and no one attended the clinic during our visit. We have considered client feedback from a client questionnaire audit conducted in January 2011.

All of the clients rated the service as very good or excellent. They were happy with the treatment they received and the attitude of the staff they met.