We carried out an announced, comprehensive inspection on 10 January 2019 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.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

CQC previously inspected the service on 3 October 2017 and asked the provider to make improvements because it was not using clinical audits to drive improvements in patient outcomes. We judged the provider had breached Regulation 17 (1) (Good governance) of the Health and Social Care Act 2008. At our 10 January 2019 inspection, we checked this area and found the area of concern had been resolved.

The Hill Medical Centre was established in 2011 and registered with the Care Quality Commission in 2013. The practice operates a private GP service for patients providing consultations and private prescriptions.

The principal doctor 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.

We received 20 completed Care Quality Commission comment cards all of which were 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:

• The provider had acted since our last inspection and introduced a programme of

regular audits to assess, monitor and improve the quality of the service.

• The practice reviewed the effectiveness of the care it provided and acted to ensure care and treatment were delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients.
• Patient feedback for the services offered was positive.
• Practice management and governance arrangements supported the delivery of high-quality and person-centred care.

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

• Review protocols to ensure that periodic water temperature monitoring is undertaken in accordance with the service’s recent Legionella risk assessment.

Dr Rosie Benneyworth 

BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Hill Medical Centre on 3 October 2017.

Hill Medical Centre was established in 2011 and registered with the Care Quality Commission in 2013. Hill Medical Centre operates a private GP service for patients providing consultations and private prescriptions.

We found this service provided safe, caring, responsive and well led services in accordance with the relevant regulations. We found this service was not providing an effective service.

Our key findings were:

• There was no programme of continuous clinical and internal audit used to monitor quality and to make improvements.

• The service had clear systems to keep people safe and safeguarded from abuse.

• There were systems in place to mitigate safety risks including analysing and learning from significant events.

• There were appropriate recruitment checks in place for all staff.

• There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients.

• The service learned and made improvements when things went wrong. The provider was aware of and complied with the requirements of the Duty of Candour.

• Patients were treated in line with best practice guidance and appropriate medical records were maintained.

• The service shared information about treatment with the patient’s own GP with their consent.

• Staff we spoke with were aware of the organisational ethos and philosophy and told us they felt well supported and that they could raise any concerns.

• There were clinical governance systems and processes in place to ensure the quality of service provision.

• The service encouraged feedback from both patients and staff.

• Systems were in place to protect personal information about patients. The company was registered with the Information Commissioner’s Office.

The areas where the provider must make improvement are:

• Ensure quality improvement initiatives are carried out including clinical audits and re-audits to improve patient outcomes.

The areas where the provider should make improvement are:

• Consider the installation of a hearing loop system to assist patients with hearing impairments.

Professor Steve Field CBE FRCP FFPH FRCGP                                 Chief Inspector of General Practice