We found patients were cared for by staff who were fit and able to do so. This was because the provider had put in place additional procedures for the process of recruiting new staff. The provider had also ensured that previously missing checks for existing staff had been performed. All staff now had proof of identity, references and criminal disclosure and barring checks in place.

We saw the provider had put in place a new policy relating to the Mental Capacity Act 2005 (MCA)and staff had read this. However, when we spoke to staff involved in obtaining consent they were not able to adequately describe how they would comply with the MCA 2005 when treating vulnerable adults who did not have the capacity to give their consent. This meant patients might not be appropriately assessed on their ability to make a decision or have their best interests considered when developing a treatment plan. Also obtaining consent from appropriate people designated to act on behalf of the patient might not be appropriately managed.

We spoke to four patients and observed one patient who received treatment on the day. The patients we spoke to told us that the staff at the practice always gained verbal consent from them before any treatment was given.

We found that staff did not have adequate knowledge in how to obtain consent from vulnerable adults who lacked capacity or who to contact if they had any concerns.

We saw that patients were greeted in a kind and considerate manner. We looked at treatment records and saw that patients were asked to complete an overall health questionnaire and were asked about any changes in their health at each appointment. One patient told us, “It’s very good” and another, “Friendly…very satisfied with the quality…pleasant environment”.

The practice had systems in place that prevented and controlled infections. We saw that the practice looked clean and tidy.

We looked at the staff recruitment records and found that these did not have appropriate checks relating to photo identification, employment history, references or disclosure and barring checks (DBS).

The practice had systems in place that assessed and monitored the quality of the service. We found that patients had the opportunity to express their views using feedback forms