We carried out an announced comprehensive inspection on 20 March 2018 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.

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.

Stanmore Private Family Practice, also known as Stanmore Private Family Physicians, is an independent GP practice located in Stanmore in the London Borough of Harrow.

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 Stanmore Private Family Practice approximately 90% of services are provided to patients under arrangements made by an insurance company with whom the servicer user holds a policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, at Stanmore Private Family Practice, we were only able to inspect the services which are not arranged for patients by an insurance company with whom the patient holds a policy (other than a standard health insurance policy).

The GP 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.

Fourteen people provided feedback about the service. All feedback we received was positive about the staff and service offered by the practice.

Our key findings were:

• There was a system in place for acting on significant events.
• Risks were generally well managed though improvements were needed in relation to safeguarding training and managing medical emergencies and safety alerts. The provider resolved these issues immediately after our inspection.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• Staff received essential training although some mandatory training was not up to date. Adequate recruitment and monitoring information was held for staff.
• Care and treatment was provided in accordance with current guidelines.
• Patient feedback indicated that staff were respectful and caring and appointments were easily accessible.
• There was a clear vision and strategy and staff spoke of an open and supportive culture. There was effective governance in most areas to ensure risks were addressed and patients were kept safe.

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

• Improve the system for monitoring staff training.
• Assess the risk of legionella bacteria at the premises.
• Review the system in place to ensure the accuracy of fridge temperatures.
• Review the process of checking the identity of patients.
• Implement clinical audit to monitor and improve quality of the service.
• Review patient access to interpreting services.

During this inspection, we spoke with three patients and two relatives of patients. They confirmed that patients had been treated with respect and dignity. Two patients stated that they were satisfied with the services provided and received appropriate advice and treatment. The rest stated that they were attending for the first time. One patient told us, "I am happy with the care. I am well treated”. A relative stated, “The receptionist treated us with respect. The doctor was ok. He explained things to us and we got what was needed”.

Records indicated that patients were assessed and their care and treatment had been recorded. Reviews of care and treatment were provided as required. Patients had been given information regarding the fees and charges. The practice had arranged for audits to be carried out regarding their treatment and care of patients. Recommendations made regarding their medical records had been responded to.

The practice had a doctor who was also the registered manager. He was supported by a receptionist. Two other part time receptionists were employed when needed. Patients made positive comments regarding staff who attended to them. There was a record of training that staff had undertaken. Staff appraisals had been completed. The receptionist and doctor were aware of action to take when responding to allegations or incidents of abuse. However, the policy had not been updated and not all staff had received training in safeguarding adults.

There was a complaints procedure and staff were aware of how complaints should be responded to. No complaints had been recorded. Staff explained that none had been received.

We saw evidence that people were given clear and detailed information about the services provided and the fees charged before their consultation with the doctor.

We spoke with four patients who had visited the surgery the day before our inspection. Everyone we spoke with told us that they were very happy with the services they received. Two people did not wish to comment on their experience, but one person told us that their whole family were treated at the clinic. They said, “I feel very comfortable with the doctor. We use him as our family doctor.” Another person did not discuss details of their treatment, but said, “I am delighted with the service, and very pleased with the doctor.”

There were effective recruitment and selection processes in place. We saw evidence that appropriate checks were undertaken before staff were employed, to show that they were fit to work with vulnerable adults and with children.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was a box in the entrance hall where people could post any comments that they wished to make. However there was no information in the surgery to inform people of how to make a complaint. One person who we spoke with said that they did not know how to make a complaint, but they were very satisfied with the treatment they received.