On the day of our inspection we were informed that two people used the service.

We saw evidence from two medical records that consent forms were signed. Staff we spoke with were aware of gaining consent for treatment. We found people were protected from the risks of unsafe care and treatment as accurate records were maintained.

People who used the service told us that information had been provided to them which had enabled them to make decisions about their care and treatment. One person said "everything from beginning to end was superb, everything was explained to us, the lady was very professional and should get a medal.” We saw staff treated people with respect and protected their dignity during their treatment.

We found that the equipment used was suitable to support the delivery of peoples’ care needs and treatment. We saw that equipment was monitored and checked to ensure it was safe for use.

We looked at servicing and checking audits for the CyberKnife equipment and found that the provider had in place arrangements for monitoring the quality of the services they were providing. One person we spoke to told us the service was “Absolutely brilliant.”

We spoke with people who use the services and they told us that they felt safe receiving care and treatment at the Centre and were treated with dignity and respect. Most people we spoke with told us that they were given information about the services and had an individualised treatment plan with appointments dates and times. People who use the service told us that they understood the care and treatment options available to them.

The CyberKnife Centre London is operated by Robotic Radiosurgery LLP. Robotic Radiosurgery LLP is an independent health care service and is part of HCA Healthcare UK. The CyberKnife Centre is located within The Harley Street Clinic, also part of HCA, but it is registered separately with CQC.

The CyberKnife Centre London provides stereotactic radiotherapy or radiosurgery treatments for privately funded patients with a wide range of benign and malignant conditions. Stereotactic radiosurgery (SRS) is a non-surgical radiation therapy used to treat functional abnormalities and small tumours of the brain. It can deliver precisely targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissue.

We inspected this service using our comprehensive inspection methodology. We carried out the announced inspection of this service on 15 and 16 December 2016. We inspected this service under the medical care core service.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

We rated this service as outstanding overall because:

• We found that staff were actively engaged in activities to monitor and improve quality and outcomes and that opportunities to participate in benchmarking, peer review, accreditation and research were proactively pursued.

• We saw many examples of innovative practice and staff could tell us about the research being undertaken by the centre and how outcomes were being embedded within clinical practice to benefit patients.

• We found excellent multidisciplinary team working. Staff, teams and services worked collaboratively to find innovative and efficient ways to deliver more joined-up care to patients.

• Feedback from people who use the service and those who are close to them was consistently positive about the way staff treated people. People told us that staff went the extra mile and the care they received exceeded their expectations.

• There was a strong, visible, person-centred culture and patients were active partners in their care. Patients’ individual preferences and needs were always reflected in how care was delivered.

• We found approachable and motivational leadership that promoted staff development and career progression, teamwork and high-quality patient-centred care.

• Governance structures were well organised and well embedded and worked effectively to ensure there were clear lines of communication between key groups.

• The service had a clear vision and strategy. Staff were aware of the corporate vision. The vision and strategy of the service was embedded into practice by staff.

• Staff told us they were well supported, and felt valued, by management and felt proud of the organisation as a place to work and spoke highly of the positive and open culture.We found there were high levels of staff engagement and that staff at all levels were actively encouraged to raise concerns.

However, we found areas of practice that required improvement:

• The risk register did not reflect all risks identified by recent incidents and near misses; managers told us that all risks identified by incidents and near misses should be recorded as risks on the centre’s risk register.

• Patient experience survey response rates were variable and were on average 17% for the 12 months prior to our inspection. Only 16 of 92 patients provided with the survey had returned it. We were told action was being taken to try to improve this.

• It was unclear how the results of the patient experience survey were used. We were not provided with any examples of where patient feedback had been used to improve services.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals