We carried out an announced comprehensive inspection on 14 February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led? The practice was previously inspected in May 2013 and was found to be meeting all the standards that were inspected.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Fleet Street clinic provides a private general practice and travel vaccination service.

This service is registered with 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. At Fleet Street Clinic services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, at Fleet Street Clinic we were only able to inspect the services which are not arranged for patients by their employers.

The practice principal 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.

Twenty people provided feedback about the service, which was positive.

Our key findings were:

• The service had systems to manage risk so that safety incidents were less likely to happen. . When incidents did happen, the service learned from them and improved.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients.
• Patient feedback for the services offered was consistently positive.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

During this visit we spoke with three patients who used the services provided at the clinic. People who used the service were highly complimentary about the skills and attitude of staff and the treatment they received. Their views and experiences were taken into account in the way the service was provided and delivered in relation to their care. One person commented, “they are kind and courteous.Very good at what they do.”

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. People were protected from the risk of infection and medicines were safely kept. There were safe recruitment procedures in place. People received care and treatment from staff who were suitably trained and skilled to an appropriate professional standard.

Patients and staff were asked for their views about their care and treatment and they were acted on. Records relevant to patients, staff and the management of the services were accurate and fit for purpose.

During the visit we did not have the opportunity to speak to any patients directly. However observation of the practices of the clinic, discussion with staff and inspection of records indicated that staff protected people’s privacy and dignity, treated them with respect, and provided a high standard of clinical care.

The premises are well maintained and kept clean and hygienic. However there is room for improvement in upgrading quality assurance procedures, risk assessing staff recruitment checks, and recording of training and supervision for the further protection of people using the service.