We carried out an announced comprehensive inspection on 7 November 2017 to answer the following key questions:

Are services:

• Safe

• Effective

• Caring

• Responsive

• 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.

Background

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 provider, Dr Ann Coxon, is registered with the CQC as an individual providing general medical services to private patients from consulting rooms at 101 Harley Street, London W1G 6AH. The provider is registered to provide the regulated activities of treatment of disease, disorder or injury and diagnostic and screening procedures. All patients are seen privately and referrals are made to private specialist consultants where required.

At this inspection we found:

• The practice had clear systems to manage risk and provide safe care and treatment.
• The premises were clean and tidy. The provider had not undertaken an infection control audit in the past 12 months but had made arrangements for this to be undertaken the following month by the theatre nurse based in the building. The provider had not undertaken recent infection prevention and control (IPC) training relevant to their role. However, IPC advice and support was available from the theatre nursing staff based in the building. An audit of antimicrobial prescribing had not been undertaken.
• Patient records were maintained in hard copy format only. Electronic patient records were not kept. Individual records were written and managed in a way to keep people safe. This included ensuring people’s records were accurate, complete, eligible, up to date and stored appropriately. However, records pending action were not always kept in a locked cabinet although the room was locked when not occupied.
• The provider ensured that care and treatment was delivered according to evidence based guidelines. The provider routinely reviewed the effectiveness and appropriateness of the care provided to ensure it was in line with current research and best practice guidance. However, formal audits were not undertaken.
• Patients were treated with compassion, kindness, dignity and respect.
• The provider understood the needs of their patients and tailored services in response to those needs.
• There was a strong focus on continuous learning and improvement.

The areas where the provider should make improvements are:

• The provider should review their process for undertaking formal clinical audit.
• The provider should review their procedures for infection prevention and control to ensure training is updated in line with the requirements of their role and regular IPC audits are undertaken.
• The provider should review the process for storing records pending action.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice