We carried out an announced comprehensive inspection on 7 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 not 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 service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The provider offers face to face consultations and examinations at the clinic and during visits to people (UK and overseas patients) in their home or other places that they are staying such as hotels or care homes. The service informed us that the majority of the patients they see are from overseas and they rarely used the clinic to see patients.

We received 27 Care Quality Commission comment cards from patients who used the service; all were all positive about the service experienced. Many patients reported that the service provided high quality care. Due to the nature of the service we were unable to speak to any patients during the inspection.

Our key findings were:

• The service had systems in place so that safety incidents were less likely to happen; however processes in place for managing risks to patient safety required improvement.
• The service did not routinely review the effectiveness and appropriateness of the care it provided; however the patient records we reviewed indicated that care and treatment was delivered according to evidence based guidelines.
• Comments cards indicated that staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients reported that they were able to access care when they needed it.
• Information on how to complain was available and easy to understand.
• Governance arrangements in place to identify and monitor risks to patient safety and performance required improvement.

We identified regulations that were not being met and the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.