We carried out an announced comprehensive inspection on 20 November 2017 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.

Background

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 independent consulting doctors service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Southern Independent Medical Practice (SIMP) is a private GP practice based in Salisbury, a city in the county of Wiltshire. The practice has occupied its current facility since 1994 and is arranged over two floors. There are GP consulting and nurse treatment rooms on both floors, and a patient waiting room on the ground floor. The practice has member patients from a wide geographical area (member patients pay a monthly or annual subscription for medical care). The practice age distribution is broadly in line with the national average, with most patients being of working age or older.

There are six GPs who are part of the practice team. Two practice nurses and one medical secretary undertake a range of additional roles. For instance, the nurses took on a wide range of roles in the practice, such as providing reception support, whilst the medical secretary also provides reception support. The practice team is completed by a practice manager and two dedicated receptionists. The majority of services are provided by a lead GP, with the other GPs working on a part-time basis.

SIMP is open from 8am to 6pm, Monday to Friday, and the practice will take calls during these times. Routine GP appointments are generally available from 8am to 6pm, Monday to Friday, and can be booked up to one year in advance.

The Nominated Individual 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.

46 people provided feedback about the service. We spoke to two patients during our inspection. Patients told us that care was ‘excellent’, and that they felt involved in decision-making about the care and treatment they received. They told us they felt listened to and supported by staff and had sufficient time during consultations to make an informed decision about the choice of treatment available to them. All of the 44 CQC comment cards we received were overwhelmingly positive and aligned with these views.

Our key findings were:

• Member patients found it easy to access appointments with a GP or nurse.
• The practice offered out-of-hours appointments if required.
• A GP was available to take telephone calls at evenings and at weekends.
• The practice offered children’s vaccination appointments.
• The practice held a register of its most vulnerable patients which was updated and monitored daily. Appointments were prioritised as appropriate.
• The practice produced a newsletter which was distributed to over 4000 patients. As well as patient feedback, the newsletter covered clinical topics of interest and the practice position on medical topics.

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

• Review cleaning schedule arrangements, and put in place an annual infection control audit.
• Review processes for disposing of medicines stock.

People we met at SIMP (Southern Independent Medical Practice) told us care was "excellent". We were told patients were "given time and not rushed" and "the GP has time to spend with me." Patients said: "I have no criticisms of my care" and "I could not fault the care." As part of their service, the practice offered patients an annual health check. Patients told us this was a "different approach" and "gives me and the GP chance to reflect on my health and consider the future."

A patient told us the practice nurses were "exceptional", "trustworthy and understanding". Patients told us the practice was able to meet their needs and protect their rights. They were treated with privacy, dignity and confidentiality.

The practice gave patients the information they needed to make their own decisions. People were given safe and effective care, treatment and support. The staff knew how to act upon any suspicions of abuse. The staff employed or contracted were qualified, skilled, experienced and fit to carry out their roles. Records held at the practice were fit for purpose and held securely and confidentially.