During our last inspections on 5 and 7 February 2014 we found shortfalls in the way the practice was assessing and monitoring the quality of service that patients received. In particular the provider did not have an effective system to monitor patients’ experience of care and treatment. We also found that the practice did not follow appropriate guidance for infection prevention and control, and staff did not receive formal supervision or training to support them in their roles.

At this inspection we found that the provider had taken action to seek the views of patients and staff, and make changes to the practice as a result. Shortfalls in infection prevention and control had been addressed, and there was now a structured training schedule to support staff in their roles.

Patients told us they received plenty of information about treatment options and that their choices were respected. One patient said, "They absolutely explained risks and benefits: not only health reasons but why they recommend treatment X over Y."

We found that needs were assessed and treatment was planned and delivered in line with people's individual treatment plans. Patients told us they were “asked thoroughly” about their health. One patient said, “They took into account my [medicine] allergy and discussed alternative options with me.” There were arrangements in place to deal with foreseeable emergencies.

We found there were systems in place to reduce the risk and spread of infection. However, in some cases appropriate guidance had not been followed, such as Department of Health guidance on the sterilising and storage of instruments.

Staff told us they were supported to carry out their roles and that they had access to training and learning events. However, there were no systems in place to ensure that staff received appropriate professional development including supervision and appraisal.

We found there were systems in place to assess and monitor the quality of the service. All staff we spoke to described the systems, although we did not have access to documentary evidence of these.