We carried out an announced comprehensive inspection on 11 December 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 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The provider 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.

Our key findings were:

• Children were accompanied by an adult during consultations. However, the provider did not undertake checks to ascertain whether the adult had parental authority.
• The provider’s emergency medicines bag contained out of date emergency equipment.
• The provider did not keep a seperate log of prescriptions that had been issued to patients.
• The provider had reviewed the effectiveness and appropriateness of the care provided. Care and treatment was delivered according to evidence based guidelines.
• The service had clear systems to manage risk so that safety incidents were less likely to happen.
• Patients reported being treated with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Patient feedback was encouraged and considered in the running of the service.
• Risks to patients were managed and mitigated.

There were areas where the provider must make improvements:

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

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

• Review the degree and scope of quality improvement activity within the service to ensure patients consistently receive high quality care.
• Review method of patient record keeping in order to improve case management and quality improvement capability.
• Regulaly review the decision to not hold oxygen as an emergency treatment option.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

People told us that they had found out about the service through medical referral and by 'word of mouth.'

One person told us they had used the service before and had returned because of a previous positive experience. They told us the service was, "You are seen quickly and you get quick results."

People agreed to the care and treatment received and people provided consent to treatment.

We found that Dr Bolia provided care and treatment for people with respect and dignity. One person told us they found the doctor “really helpful” and they felt “listened to”. One person told us when they contacted the service to make an appointment they found Dr Bolia helpful and described him as being, "Very efficient and was offered a number of options".

One person told us they were happy with the service that Dr Bolia offered. They said "Dr Bolia is very responsive and flexible with offering appointments."

Dr Bolia was aware of local safeguarding policy and able to demonstrate awareness of the signs of abuse and actions to be taken following an allegation of abuse.

Dr Bolia was supported with his professional development and was provided with opportunities for training and professional registration.