We carried out an announced comprehensive inspection on 31 March 2016 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.

Our key findings were:

• There was an effective system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand. Complaints were fully investigated and patients responded to with an apology and full explanation.
• Risks to patients were always assessed and well managed.
• The practice held a comprehensive central register of policies and procedures which were in place to govern activity.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider actively encouraged patient feedback and acted upon it.
• The provider was aware of and complied with the requirements of the Duty of Candour.

At our previous inspection of this service we identified concerns regarding the provider’s lack of systems to regularly assess and monitor the quality of service that patients received and we asked them to take action.

Prior to this inspection we reviewed information the provider had sent us. At the inspection we spoke with members of staff and looked at records.

We found that the provider had taken action and there were now systems in place to ensure the effective and safe management of the practice.

There was now a system in place to carry out regular audits, act on the findings and share learning with staff members by means of practice meetings.

Feedback from patient surveys had been reviewed and audited in order to identify any trends and changes to practice that may have been needed in order to improve the service.

The provider acted on risks which had been identified as part of their quality monitoring systems.

We spoke with three patients. They were all very satisfied with their treatment. Comments about the service included: “I felt cosseted – as though they cared and they’d got time to listen to my small concerns” and “I can’t speak highly enough about the place.” We found the provider was protecting people from unsafe treatment by assessing them individually. One of the patients we spoke with told us: “I’ve never ever had such a wonderful explanation. The examination was very gentle.” People gave consent before any assessment or treatment was provided.

We found that medicines were managed safely. One patient we spoke with told us the GP routinely called them after prescribing a new medicine, to check they were taking it correctly and to check whether they were having any side effects.

The patients we spoke with were confident staff were qualified and competent in their roles. When we asked patients if they were confident in staff, one person replied: “100 per cent.” Another said: “The staff were exceptional.”

Two of the three patients we spoke with had been asked for their views about the service. One commented: “It would be very difficult for them to improve the service.” We found the provider was checking the quality of the service they provided and making improvements when they identified gaps. However, they did not have a system to ensure quality was regularly assessed and monitored.