We carried out an announced comprehensive inspection on 5 April 2018 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.

The services inspected included provision of travel immunisations and private GP consultations for people who either sought a second opinion or access to an immediate appointment. Some patients also used the service to obtain a private health assessment. There was also a system in place for parents of patients aged under 16 to confirm their identity when these younger patients attended for travel immunisations.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At The Lanes Medical Practice services are provided to patients under arrangements made by their employer and a government department. These types of arrangements are exempt by law from CQC regulation. Therefore, at The Lanes Medical Practice, we were only able to inspect the services which are not arranged for patients by their employers and government departments.

The provider is an individual registered with the Care Quality Commission to manage the service. Individuals registered have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Prior to the inspection we asked for feedback from patients by providing CQC comment cards to the practice four weeks in advance. We received 17 completed CQC feedback cards. All the patients who provided feedback were positive about the service they received. Patients described the service as caring, personalised and professional.

Our key findings were:

• Systems were in place to protect people from avoidable harm and abuse.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Information about the service and how to complain was available.
• There was a clear leadership structure and staff felt supported by the provider and worked very well together as a team. The provider was aware of the Duty of Candour.
• The premises were appropriate to the service delivered and were accessible to clients with mobility difficulties.
• There were appropriate arrangements in place to share information with the patients’ registered GPs.
• There was an effective system to deal with blood samples and test results.
• The system in place to receive feedback from patients did not include those patients receiving services subject to regulation.

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

• Review and improve the process in place in relation to the use of patient group directions for administration of vaccines to ensure this is in line with National Institute for Health and Care Excellence (NICE) guidance.
• Improve quality improvement methods to carry out medicines audits to include antibiotics and hypnotics.
• Monitor the effectiveness and sustainability of the changes made to procedures at the time of, and immediately following, inspection.
• Review the processes in place to obtain and act upon patient feedback from patients receiving services subject to regulation.

We carried out an inspection on 07 February 2013 and published a report setting out our judgements. We asked the provider to send us a report of the changes they would make to comply with the standard of cleanliness and infection control. We followed up on our inspection of 07 February 2013 to check that action had been taken to meet this standard.

We were not able to speak to people as part of this inspection.

In February we found failings in the standard of cleaning. Since then the provider had made changes to ensure the premises were cleaned appropriately. When we visited in June we found the premises were clean, tidy and well maintained.

The service had a small number of employed staff. Recently a second doctor had joined the practice to provide occasional cover for the principal doctor. We found not all the required recruitment checks had been carried out and documented.

There was a complaints procedure in place although the service did not have any complaints recorded.

We spoke to three people who used the service during our visit. They all spoke positively of their experiences and the care they had received. One person told us" The service is very comprehensive and I have no complaints at all." We found that the atmosphere within the practice was calm and people were treated with courtesy and given a personal service.

People were provided with full information about their treatments and had been able to make informed decisions about their care.

The premises were tidy and well maintained however we found that improvement was needed in the management of cleaning standards.

Clinical staff were trained and qualified to provide the service and administrative staff felt happy and supported in their work.

There was a system in place to monitor the running of the service and to implement improvements where feedback or learning from experience and events indicated there was scope to do so.

On this occasion we were not able to speak to anyone attending the clinic for treatment at the time of the visit, however we randomly selected four people who were all happy to speak to us on the phone after the inspection.

People told us they were happy with service provided by Lanes Medical Practice. They said they were informed about costs of treatment over the phone at the time of making the appointment. People said they felt the consultations were thorough and informative.