We carried out an announced comprehensive inspection on 11 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.

Colney Medical Centre (the location) is described as a Specialist Community Clinic and provides a range of specialist gynaecology services to patients aged over 16 years. The Clinic is commissioned by the Hertfordshire Valley Clinical Commissioning Group and Barnet Clinical Commissioning Group to provide care and services to patients under an NHS funded agreement.

Services include a range of testing, screening and treatment processes undertaken by a GP with a Special Interest (GPSI) in Gynaecology or a Consultant Gynaecologist as appropriate. Patients are referred to the Clinic by their GPs for gynaecological assessments and/or treatments. All referrals are triaged by a Consultant or GPSI upon receipt. Following review of referral, the service either provides further advice to the referring GP with regard to patient care, refers the patient onto secondary care for assessment or treatment within an acute hospital setting or arranges for the patient to be seen within the Specialist Community Clinic by a GPSI in gynaecology or a Consultant Gynaecologist as needed.

The Chief Executive and Finance Officer 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.

We received 30 completed CQC comment cards. All the completed cards indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. In addition, comment cards described the environment as pleasant, clean and tidy.

Our key findings were:

• The provider had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Staff assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards.
• Patients were treated with dignity and respect and they were involved in decisions about their care and treatment. Treatment was delivered in line with best practice guidance and appropriate medical records were maintained.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• The service actively sought feedback from patients and displayed the results and actions taken in response to feedback received.
• Systems were in place to protect patients’ personal information.
• Information about services and how to complain was available and easy to understand.
• An induction programme was in place for all staff and all staff received role specific training.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The provider had a clear vision to provide a safe and high-quality service and there was a clear leadership and staff structure. Staff understood their roles and responsibilities.
• There were clinical governance systems and processes in place to ensure the quality of service provision. We saw that there was a system for managing significant events and that learning and improvement was encouraged.
• Staff had access to all standard operating procedures and policies which were regularly reviewed and updated.

The areas where the provider should make improvements are:

• Review emergency medicines to ensure that stocks of medicines held are appropriate for the needs of the service.
• Review and improve the process for undertaking and recording checks of emergency equipment.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During our inspection visit on 02 January 2014, we spoke with three people who used the service. The people we spoke with said that they were very happy with the service they received. One person said “I have visited the centre three to four times and I have found that the staff were very helpful and I did not have to wait long to see my doctor. I have had lots of tests and at the moment I am happy with the treatment. I have no concerns.” Another person said “This was my first visit. I had been referred by my GP. The staff, including the doctors were very professional and efficient. The doctor discussed the next step of my treatment with me and I felt calm and reassured.”

We found that the provider was meeting the standards we had inspected. People had been involved in the decisions about their treatment and their privacy and dignity was respected. People received treatment as discussed and agreed by them. There was a system in place to control the spread of infection. Staff had been provided with the relevant training so that they were competent in their roles. There was a quality assurance system to assess and manage the quality of service.