We carried out an announced comprehensive inspection at Berkshire Health Craven Road on 18 October 2017. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Berkshire Health Craven Road on our website at www.cqc.org.uk.

Berkshire Health Craven Road operates under the name of The Forbury Clinic.

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.

This inspection was an announced focused inspection carried out on 1 May 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 18 October 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

CQC inspected the service on 17 October 2017 and asked the provider to make improvements regarding the lack of a system for monitoring medicine and safety alerts and a lack of risk assessments relating to the accessibility of the emergency medicines and equipment. We checked these areas as part of this focused inspection and found these had been resolved.

The service has a registered manager. 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.

Our key findings were:

• Arrangements for actioning medicine and safety alerts kept patients safe.
• The contents and accessibility of the emergency medicines and equipment had been assessed and actions undertaken to improve this.

We carried out an announced comprehensive inspection of Berkshire Health Craven Road based in Reading on 18 October 2017 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 not 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.

Background to Berkshire Health Craven Road

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 Berkshire Health Craven Road was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Forbury Clinic was founded in 2011 and has two sites, 'The Forbury Clinic - Kendrick Road' and ‘The Forbury Clinic - Craven Road' both situated close to the centre of Reading, Berkshire. This inspection was of The Forbury Clinic – Craven Road. As The Forbury Clinic has grown, its specialties’ covered have expanded to include Urology, Spinal Surgery, Plastic Surgery, Gynaecology, Physiotherapy, ENT Surgery, Eye Surgery, Oncology, Medical Imaging, Antenatal Scanning, Hand Surgery, Bariatric Surgery, General Surgery, Speech Therapy and Ophthalmology.

The Forbury Clinic is a group of surgeons and medical professionals who aim to provide the highest standard of care and treatment within comfortable and spacious surroundings. They operate from two buildings 11 Kendrick Road and 23 Craven Road, both purposefully refurbished to provide consulting, diagnostic and treatment over a variety of specialty areas of medicine and surgery.

The consultants hold substantive posts at NHS hospitals and appear on the General Medical Council (GMC) Specialist Register. The service is also supported by a team of specialist nurses and healthcare professionals and a team of administrators.

All registered services for this inspection are provided from:

• Berkshire Health Craven Road , 23 Craven Road, Reading , RG1 5LE

This service is registered with Care Quality Commission (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 premises at Berkshire Health Craven Road consisted of a three storey building. The ground floor consisted of a reception area, a consulting room, a treatment room, and the practice managers office. There were three further consulting rooms and a treatment room on the second floor and a further treatment and consulting room on the third floor.

The quality assurance manager is the registered manager. (A registered manager is someone who has been selected by a provider to be legally responsible for managing regulated activity from a provider location).

The service was open between 9am and 5pm Monday to Friday. Out of regular clinic hours patients were advised to contact their GP or the local hospital if required.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. All of the 46 patient comment cards we received were positive about the service experienced. Patients said they felt the Berkshire Health Craven Road offered an excellent service and staff were efficient, helpful and caring. They said staff treated them with dignity and respect and the care they received exceeded their expectations. Patients stated they felt all the staff took an interest in them as a person and overall impression was one of wanting to help patients.

Our key findings were:

• There was an effective system in place for reporting and recording significant events.
• Procedures were in place for monitoring and managing risks to patient and staff safety. For example, there were arrangements to prevent the spread of infection and compliance with these was monitored. However, the provider did not receive patient safety and medicine alerts. This was rectified on the day of inspection.
• The safeguarding lead was one of the nursing team and they had completed adult safeguarding training and level three safeguarding children training. All staff had completed appropriate levels of child safeguarding training relevant to their role.
• Procedures for emergency medicines and equipment needed to be reviewed and risk assessed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about their care.
• Staff were supported to receive training appropriate to their role and to keep up to date with developments and best practice.
• All written and verbal feedback from patients told us they had very positive experiences of the service and felt they were treated with respect, compassion and dignity.
• Treatment plans were tailored to individual needs and according to the best options for treatment at that time.
• Patients told us they had flexibility and choice to arrange appointments in line with other commitments. Patients also commented that they were offered cancellation appointments if these were available.
• Information about services and how to complain was available and easy to understand.
• There was a clear staffing structure and staff were aware of their own roles and responsibilities.