We carried out an announced comprehensive inspection on 1 November 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 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 not 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.

The service provides pregnancy and fertility services to fee-paying patients alongside other medical specialties. Carmenta Life offers a range of diagnostic and screening procedures using a range of high quality equipment and laboratory tests. This includes blood pressure, pregnancy health advice and ultrasound scans. Laboratory investigations includes a range of diagnostic and screening of blood tests and cytology samples.

The lead clinical consultant is the 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.

As part of our inspection, we asked for Care Quality Commission comment cards to be completed by patients prior to our inspection. We received four comment cards which were positive about the level of care provided. Patients told us staff were reassuring and gave them the time to ask questions.

Our key findings were:

• There was no oversight of the risks associated with the service. For example, there had been no risk assessment completed for the premises, health and safety, fire, legionella or emergency medicines.
• Staff did not receive regular appraisals and one staff member had not completed mandatory fire or infection control training.
• An infection control audit had not been completed to identify or address concerns.
• Clinical records were detailed and held securely. The service did not keep paper records.
• Staff members were knowledgeable and had the experience and skills required to carry out their roles.
• There were no practice meetings or formal communication with staff.
• The provider did not document verbal complaints received however, the provider was able to give examples of how verbal complaints had led to improved care.
• Patients were able to book appointments directly with the practitioners at a time that was convenient to them, this included at evenings and weekends.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Improve the process for recording verbal consent obtained from patients to undertake examination or treatment.
• Improve communication mechanisms with staff members.
• Improve the safeguarding policy to include a safeguarding lead for the service.
• Improve the complaints policy to include the advertising of the complaints procedure on the website, the recording of verbal complaints and recording actions taken.

You can see full details of the regulations not being met at the end of this report.

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