10 Harley Street

Updated 10 July 2019

10 Harley Street is an independent health service based in London and Hertfordshire. The provider, Home Health Service Limited, offers private GP services to both adults and children. The service provides home visits to patients in parts of London and Hertfordshire, and consultations at 10 Harley Street in central London. The service rents the room at 10 Harley Street when necessary, but staff who work at these premises are not employed by the provider.

The service is registered with the CQC to provide the regulated activity of treatment of disease, disorder and injury.

Appointments are available upon request at the 10 Harley Street premises from Monday to Friday from 9am to 8pm and on weekends from 9am to 5pm. Home visits are available from Monday to Sunday from 8am to 10pm.

We carried out this inspection as a part of our comprehensive inspection programme of independent health providers.

The inspection was carried out on 14 May 2019 and we attended the 10 Harley Street premises where the GP sometimes carries out appointments. During the visit we:

• Spoke with the GP.
• Reviewed a sample of patient care and treatment records.
• Reviewed patient feedback.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 10 July 2019

The full comprehensive report following the inspection on 22 May 2018 can be found by

selecting the ‘all reports’ link for 10 Harley Street on our website at .

We carried out an announced comprehensive inspection at 10 Harley Street 14 May 2019 to follow up on breaches of regulations.

CQC inspected the service on 22 May 2018 and asked the provider to make improvements regarding;

• Adult safeguarding training was not up to date.
• Verbal consent from patients was not recorded.
• No emergency medicines were carried by the GP to home visits and there was no risk assessment to support this decision. There was no risk assessment in respect of the emergency equipment available at 10 Harley Street.
• Vaccines were occasionally stored overnight in a domestic fridge containing food.
• The thermometer, portable sphygmomanometer and adult pulse oximeter had not been calibrated.
• There was no process documenting how patients were informed that chaperones are not available for home visits and there was no risk assessment regarding staff at 10 Harley Street having appropriate chaperone training and DBS checks.
• No quality improvement activity had been completed, such as clinical audits.
• There were no systems for ensuring oversight and management of some risks, including in relation to emergency equipment and chaperones.

We checked these areas as part of this comprehensive inspection and found this had been resolved.

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 sole GP at the service, who runs Home Health Service Limited, is the registered manager. A registered manager is a person who is registered with the CQC 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 asked for CQC comment cards to be completed by patients prior to the inspection and these were sent to 10 Harley Street in central London. No patients attended an appointment at the 10 Harley Street premises during the two weeks the comment cards were available, and therefore no comment cards had been completed.

Our key findings were :

• The service had appropriate systems to safeguard children and vulnerable adults from abuse, and the GP had completed up to date adult and children safeguarding training.
• The GP had had an enhanced Disclosure and Barring Service (DBS) check and was registered with the General Medical Council (GMC).
• At the time of inspection, no emergency medicines were carried by the GP to home visits and a risk assessment had been completed to support this decision. A risk assessment had been completed in respect of the emergency equipment available at the 10 Harley Street premises.
• Clinical equipment used by the GP such as thermometer, portable sphygmomanometer and adult pulse oximeter had not been recently purchased and the provider intended to purchase annually.
• The GP received medicines and other safety alerts by email from the Independent Doctors Federation, and demonstrated an awareness of recent safety alerts, although there was no system in place to document these.
• Individual care records were written and managed in a way that kept patients safe, and referral letters were thorough and contained all of the necessary information.
• Blank prescriptions were kept securely and arrangements for dispensing medicines at the service kept patients safe. The provider was aware of their responsibility to respect people’s diversity and human rights.
• Patients were able to access care and treatment from the clinic within an appropriate timescale for their needs.
• There was a complaints procedure in place and information on how to complain was readily available.
• Governance arrangements were in place. There were clear responsibilities, roles and systems of accountability to support good governance and management.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care