When we inspected on 27 February 2014, the provider did not have a system in place for routine staff supervision and appraisal. This meant that it was failing to comply with the requirements of regulation 23 of the Health and Social Care Act 2008 (HSCA). At this inspection, we noted that staff supervision and appraisal meetings had recently taken place and judged that the action taken was sufficient to comply with the requirements of the regulation.

When we inspected in February 2014, the provider did not have routine systems in place for gathering patients’ views about the service offered. This meant that the provider was failing to comply with the requirements of regulation 10 of the Health and Social Care Act 2008 (HSCA). At this inspection, we saw that a patient survey and had taken place and the provider was able to evidence improvements made to the service based upon the feedback. We judged that the action taken was sufficient to comply with the requirements of the regulation.

Patients we spoke with were complimentary about the service. One said "Mr Monkman runs a family oriented practice for the local community. I would travel here even if we moved." Medical histories were regularly taken to identify and minimise any potential risks to patients. There were arrangements in place to deal with foreseeable emergencies. Drugs and equipment recommended by the Resuscitation Council UK (RCUK) were almost all in place and staff regularly undertook basic life support training.

The practice had systems to reduce the risk and spread of infection. There were plans in place to ensure the premises had a separate decontamination room .

Although staff had received training to enhance their knowledge and skill, some areas were completed regularly . Expected supervisions and appraisals did not occur. The practice did not have systems in place to assess and monitor the quality of the service provided. This included gathering patients’ views. Whilst patients we spoke with on the day of the inspection told us they were happy with the service, a lack of a systematic approach to quality monitoring meant that patients could not be sure of the effectiveness of the provider's quality measures.