We were unable to speak to people on the day of this inspection as there were no appointments made. We looked at the returned quality assurance questionnaires collated in August 2013. People described the service as "fantastic" and "amazing" and said that they had completed medical questionnaires. Written information was provided to people on how to look after themselves following surgery which included details on taking medications, eating and drinking, activities and exercise. The service also provided aftercare advice to people who would be looking after the patient at home.

In the questionnaires people using the service said that it was always clean when they visited. There was a policy and procedure in place for reducing the risk of infection.

The environment was seen to be clean and tidy on the day of this inspection. All areas were bright, well furnished and comfortable. The staff completed regular health and safety checks including fire alarm checks.

Appropriate checks were undertaken before staff began work. These included staff's right to work in the UK, Disclosure Barring Service checks, their professional registration, Hepatitis B status and health checks to ensure that they were fit to work.

108 Medical Limited - Harley Street had an effective quality assurance procedure ensuring that the quality of service provided was monitored and relevant improvements were implemented where needed.

People who had used the service told us that they were given information about their care and treatment before they underwent procedures. They said that staff were "very professional", "fantastic" and "very welcoming".

People who had used the service described it as "very good" and "excellent". Appropriate medical checks were undertaken before people received treatment and they received appropriate after-care. Staff had been trained in what to do in a medical emergency and there were emergency drugs and equipment available.

Staff were trained in safeguarding vulnerable adults and child protection. There was a policy and procedure in place for how to report any concerns, including to the local authority.

When staff started at the service they received an induction. Staff undertook mandatory training on an annual basis, including safeguarding and what to do in a medical emergency. There was a procedure in place for them to undergo annual appraisals where their performance would be discussed and targets set for the coming year.

Staff at the service monitored the clinical outcomes of the treatment of patients. Regular patient feedback questionnaires were completed. People using the service told us that they would be happy to raise any concerns with staff if they had any.

The majority of people spoken to were very positive about the service provided to them. Spending time in the waiting area staff were seen to liaise with all patients in a respectful dignified manner.

Quality assurance audit records from April 2011 informed that the patients that had used the service were overall happy with the treatment and after care support provided.