We carried out an announced comprehensive inspection on 16 October 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 service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Notting Hill Private Medical Practice Limited provides private medical services at The Portobello Clinic in the Royal Borough of Kensington and Chelsea, London. Services are provided to both adults and children.

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. Notting Hill Private Medical Practice Limited provides a range of therapies, for example: complimentary therapies, physiotherapy and podiatry which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

We received feedback from 31 people about the service, including comment cards, all of which were very positive about the service and indicated that patients were treated with kindness and respect. Staff were described as helpful, caring, thorough and professional.

Our key findings were:

• There were arrangements in place to keep patients safe and safeguarded from abuse.
• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines across most areas of practice.
• Staff treated patients with compassion, kindness, dignity and respect and patients felt fully involved in their care.
• The clinic understood the needs of its population and tailored services in response to those needs.
• Patients found the appointment system very easy to use and reported that they were able to access care when they needed it.
• The service had a clear procedure for managing complaints. They took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• Leaders had the skills and capacity to deliver the service and provide high quality care.
• Staff stated they felt respected, supported and valued. They were proud to work in the service.
• The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.
• There were clear governance arrangements and systems to monitor performance and risk, however some areas of clinical governance required a review to ensure quality of the service was monitored.

Notable practice:

• One GP ran a six-week evidence based programme in the evenings for patients on stress management and resiliency training to help avoid reliance on medicines and onward referrals. The sessions were given to small groups of around eight to ten patients at a time and included a blend of techniques such as mindfulness, meditation, cognitive behavioural therapy and other psychological techniques.

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

• Monitor prescribing activity to ensure prescribing is in line with recommended guidance.
• Review the systems for monitoring the quality of medical records.

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

We spoke with people who use the service and looked at recent feedback that people had sent to the provider. Overall, people were very satisfied with the care and treatment they had received. One person described their GP as 'awesome' and another thanked the service for the "special care" they received. People felt involved in making decisions about their care and GP's notes included details of further tests required and any additional costs involved.

Staff were trained to deal with emergencies and there was emergency equipment available. Care was delivered in a way to ensure a person's safety. If required, the GP would refer the person to a specialist or carry out further tests. Where people were referred on, the GP gave them a follow-up appointment to check whether their condition was being treated.

The appropriate checks had been carried out on staff before they began work and people who use the service were complimentary about the quality of staff.

There were systems in place to monitor the quality of the service. Complaints and comments were listened to, investigated and dealt with. Practice meetings took place weekly and covered a variety of issues, including feedback from people who use the service. Incidents were reported and analyses of the causes were undertaken. The provider was in the process of implementing an online feedback system.