We carried out an announced comprehensive inspection on 6 November 2017 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.

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.

Japan Green Medical Centre is registered with the Care Quality Commission to provide Diagnostic and Screening procedures, Maternity and midwifery, surgical procedures and Treatment of Disease, Disorder, Injury (TDDI).

Japan Green Medical Centre (JGMC) provides primary healthcare services for Japanese patients living in the West London area. The centre offers private consultations with doctors in a range of specialties ranging from range from GP services, medical emergency care, health checks, ultrasound, women's and children's care.

The clinics opening times were  Monday-Friday 9am-7pm. Saturday ,Sunday and bank holidays 9am-5pm. When the clinic was closed had a recording message on their answer phone that directed patients to other fee paying services in hospitals in the city.

The clinic has 5854 patients registered and they undertake approximately 8504 consultations per year.

The cost of the service for patients is advertised on the website and detailed on the patient consultation forms and prices are also displayed in the clinic.

The service employs

eight full time

doctors

and four

part time

doctors

across

the providers other location in London City. All these doctors attained their training in Japan and are also registered with the GMC. The clinic has two full time nurses with both Japan and NMC registrations. Other staff at the practice are health care assistants undertaking phlebotomy roles,pharmacy assistants(the pharmacy assistants are qualified pharmacists from Japan, and they work under the supervision of a GMC registered doctor) ,a full time health service manager and a practice manager.

The principle GP who is the organisation’s Director is also  the CQC registered manager. The Chief executive officer is registered as the Nominated individual.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 obtained feedback about the service from 35 patient Care Quality Commission comment cards that had been translated into Japanese. All patients comments were positive about the service experienced. Patients said they felt the practice offered an excellent service as they could access it seven days per week. Patients reported that staff were helpful, caring and treated them with dignity and respect. We also spoke with three patients on the day. They told us they were satisfied with the care provided by the practice and said their dignity and privacy was respected.

Our key findings were:

• There was an effective system in place for reporting and recording significant events.
• Risks to patients were always assessed and well managed, including those relating to recruitment checks.
• The clinic had a number of policies and procedures to govern activity.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named healthcare professional and that there was continuity of care, with urgent appointments available the same day.
• The clinic had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The clinic proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Maintain the recently developed policy for following up test results.
• Develop a specific policy for dealing with sepsis.

During our visit to the service we spoke to two people who use the service. They told us that they felt respected by all the staff and they were informed about their treatment. They said they were involved in planning any future treatment needs and could choose which secondary care services referrals could be made to, such as NHS or private hospitals.

We found that appropriate systems were in place for the management of infection control and staff received training and development in their work.

However, feedback we received from some people who use the service was that their privacy was not always respected. This was specifically in relation to needing to complete forms, and being informed about their medicines, in the waiting area of the service.