We carried out an announced comprehensive inspection on 30 January 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.

Basuto Medical Centre is an independent private GP service located in the residential area of Parsons Green, South West London. The service provides primary medical services for fee-paying patients.

As part of our inspection, we asked for CQC comment cards to be completed by patients. All the 29 patient comment cards we received were positive about the service experienced. Staff were described by patients as very caring, considerate, courteous, attentive and kind. Some comments referred to the efficiency of making an appointment and unhurried consultations. We were unable to speak with any patients directly at the inspection.

Our key findings were:

• The service had systems and processes to minimise most risks to patient safety.
• The service had adequate arrangements for response to medical emergencies and major incidents.
• There was a process for reporting and investigating significant events and incidents, but documentation did not provide clarity of reflective analysis and learning.
• Staff received essential training, and adequate staff recruitment and monitoring information was retained.

• There was some evidence of quality improvement activity and clinical audit initiatives. Patient feedback indicated that staff were caring and courteous and treated them with dignity and respect.

• The service responded to patient complaints in line with their policy.
• The service had good facilities and was equipped to treat patients and meet their needs.
• There were systems in place to collect and analyse feedback from patients.
• The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.

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

• Review the arrangements for the disposal of sharps used to administer cytostatic medicines.
• Review the arrangements for not requiring patients to provide identification when registering with the service.
• Consider incorporating more detailed reflective analysis and learning in the documentation of significant events and incidents.
• Further develop quality improvement activity to include complete clinical audits.
• Review the 18-month cervical screening reminder process to ensure inclusion of all relevant patients and embed the newly implemented process for inadequate sample monitoring.
• Review the systems for identifying the learning needs of clinical staff.

We spoke with three patients during our visit. These patients were very satisfied with the service they received from their GP. One of the comments we received was "it's a great practice". We observed patients being treated with dignity and respect. A patient commented that staff were "polite and friendly." Patients understood the care and treatment choices available to them and felt they were given appropriate information and support regarding their care or treatment. In general patients were able to make an appointment to see their GP without many problems.

Care and treatment was planned and delivered in a way that was intended to ensure patient's safety and welfare. A patient told us "doctors have been very thorough and have always given me time".

Patients said the practice was clean. There were systems in place to control the spread of infection.

There were effective recruitment and selection processes in place to ensure patients were cared for by suitably experienced and qualified staff.

Basuto Medical Centre had an effective quality assurance procedure ensuring that the quality of service provided was monitored and relevant improvements were implemented.

People who use the service were not available for interview during our visit. There were questionnaires and other information that people had completed. These told us that people were satisfied with the service provided. They had the consultation procedure and treatments explained to them including any risks that may be attached to them.

They did not directly comment on the clinic's quality assurance system or number of staff but did tell us they were happy with the service they had received and way it was delivered.