We carried out this announced comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection on 22 June 2018 was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we 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 Information

This was a planned comprehensive inspection to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Pinches Medical is registered with the Care Quality Commission (CQC) as an independent provider of GP consultations and treatment and medical services for children and adults. It is situated in Macclesfield, East Cheshire. Patients are self-referring and there are no geographical boundaries to using the service.

People access the service by signing up to different levels of membership paid for monthly, or by arranging individual appointments. All appointments are pre-booked.

The service registered with the CQC in July 2017 to provide the following regulated activities:

• Diagnostic and screening services
• Family Planning services
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease and disorder and injury.

The service employs doctors, nurses and other health care professionals on a salaried or sessional basis.

The service provides a full range of medical care and treatment which includes: gynaecology; diagnostics, treating adult and childhood illnesses and immunology treatment.

The medical and clinical team consists of:

• Four doctors.
• Two registered nurses.
• One physiotherapist.
• One counsellor.
• One health care assistant.

The doctors and other health care professionals are supported by the practice manager and a team of administration and reception staff.

The service was registered with the Care Quality Commission in July 2017.

The service is situated on the second floor of a historical building in Macclesfield. There is full disabled access which includes a ramped walk way, lifts to all floors and wide doorways into the waiting areas and consulting rooms. The facilities include; two waiting areas, one on the ground floor and another at the entry to the consulting and treatment area; consulting rooms and one treatment room; toilets, including easy access, store rooms; a meeting room and offices used by administration staff.

The opening times are Monday to Friday 8am to 8pm and Saturday 10am to 3pm. Patients can arrange for appointments at their own convenience.

At Pinches Medical the aesthetic cosmetic treatments that are also provided do not fall under the regulated activities regulated by CQC.

The provider was also 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.

Seven people provided feedback about the service, this included completed CQC comment cards. Feedback was mostly positive. Patients confirmed they felt listened to and were treated with compassion and kindness. Feedback included that patients felt happy because they were not rushed and the environment had a calming effect. Patients also told us they trusted the professionals they saw and felt that their treatment was effective in aiding recovery or referral to a specialist service.

Our key findings were:

• Patients were treated in line with best practice guidance and appropriate medical records were maintained.
• Systems were in place to promote effective communication with the patients NHS GP.
• The service had effective systems in place to ensure they were included in communications about concerns or incidents sent by the local Clinical Commissioning Group and other organisations.
• An induction programme was in place for staff, staff had access to appropriate training, staff had access to key policies and procedures and there was good communication within the service.
• Information about services available and how to complain was available.
• The service encouraged feedback from both patients and staff.
• Systems were in place to protect personal information about patients. The company was registered with the Information Commissioner’s Office.
• The service had systems to keep people safe and safeguarded from abuse; however, the safeguarding policy needed to be updated and this was done following the this inspection.
• The service had a programme of ongoing quality improvement activity.
• Effective governance systems and processes were in place.

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

• Review how staff compliance with completing mandatory training is monitored.