We carried out an announced comprehensive inspection of The Mews Practice on 4 September 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.

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.

The practice provides independent general practitioner services to the population of Guildford and the surrounding area.

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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The Mews Practice provides regenerative therapies and nutritional support which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

At The Mews Practice, the regenerative therapies and nutritional support that are also provided are exempt by law from CQC regulation. Therefore, we were only able to inspect the treatment for weight reduction, but not the Regenerative Therapies and nutritional support services.

The previous registered manager had left the practice and the practice were in the process of registering a new registered manager with CQC. 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.

Forty people provided feedback about the service via comment cards all of which was positive about the standard of care they received. The service was described as excellent and staff were described as professional and caring. Patients felt that they were treated with dignity and respect, were involved in their own care, were listened to and received clear explanations of their options. We also looked at a random sample of feedback cards that the practice encouraged patients to fill in and all were very positive about the service. Five patients had provided reviews on internet review sites and all five reviews gave the service five out of five stars.

Our key findings were:

• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based research or guidelines.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Appointments were available seven days a week.
• The practice was proactive in seeking patient feedback and identifying and solving concerns.
• The service was offered on a membership basis or a private, fee paying basis to adults and children.
• The culture of the service encouraged candour, openness and honesty.

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

• Review and implement the new policy on checking patient identification.
• Review training reception staff in the recognition of signs and symptoms suggestive of sepsis.
• Review the implementation of an audit in to the prescribing of antibiotics in the practice.

• Review the process for recording a review date on to written policies and procedures.