112 Harley Street

This service is rated as Good overall. (Previous inspection 2 February 2022 – Requires improvement)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at 112 Harley Street, to follow up on breaches of regulations.

The service is a small private GP practice with cardiac services. CQC inspected the service on 2 February 2022 and asked the provider to make improvements regarding significant events and safety management, staff recruitment and training and overall governance. We checked these areas as part of this comprehensive inspection on 23 February 2023 and found the required improvements had been made.

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 general 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 112 Harley Street, services are provided to patients under arrangements made by their employer/ a government department/an insurance provider with whom the servicer user holds an insurance policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, at 112 Harley Street, we were only able to inspect the services which are not arranged for patients by their employers/ a government department/an insurance provider with whom the patient holds a policy (other than a standard health insurance policy).

One of the doctors at the service 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.

Our key findings were:

• The service had succeeded in making a range of improvements. For example, the service had comprehensive policies and established reliable systems to keep people safe. Policies and procedures were maintained in an organised way and easily accessible to staff.
• There were safe procedures for managing medical emergencies including access to emergency medicines and equipment.
• The premises were clean and well maintained. There were effective systems in place to reduce the risk and spread of infection.
• Leaders had established policies, procedures and activities to ensure safety and had assured themselves that they were operating as intended.
• Records were written and managed in a way to keep people safe. Patient notes were easily accessible in an emergency and it was possible for the provider to share information with other services when there was an urgent need.
• Patients’ needs were effectively assessed, and care and treatment were delivered appropriately. The service prescribed medicines safely.
• Patients were treated with kindness, respect and compassion. Staff helped patients to be involved in decisions about their care and treatment.
• The provider had implemented a sustainable action plan to address the issues we identified at the last inspection. For example, the governance arrangements had been strengthened, especially in relation to identifying, managing and mitigating risks.

The areas where the provider should make improvements are:

• Take action to ensure that information about how to make a complaint is displayed in the clinic.
• Make access information available for patients on the service website.
• Continue to improve the safety alerts protocol to ensure that it remains effective and relevant.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services