The Care Quality Commission
  • Doctor
  • Independent doctor

Medicaoptima Ltd

Overall: Good read more about inspection ratings

4 Back Lane, Richmond, Surrey, TW10 7LF (020) 8332 7190

Provided and run by:
Medicaoptima Ltd

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Medicaoptima Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Medicaoptima Ltd, you can give feedback on this service.

20 February 2020

During a routine inspection

This service is rated as Good overall. We had previously carried out an announced comprehensive inspection of Medicaoptima Ltd in March 2018. At that time the service was not rated. It was judged to be providing a service that was meeting the requirements, however there were some areas the provider should make improvements. We re-inspected the service on 13 June 2019, and the same issues were still present at that inspection, and it was rated as inadequate overall, inadequate for effective and well led, requires improvement for safe and good for caring and responsive. The specific issues that led to the rating of inadequate were:

  • The provider had not established a clear policy in respect of the arrangements in place to safeguard children and vulnerable adults from abuse; different versions of policies were in place, containing different information and not all were filed in a way that would enable easy access. Non-clinical staff had not received training in adult safeguarding.
  • The provider had not ensured that electrical equipment was safe to use, as portable appliance testing had not been carried out.
  • The provider had not maintained a comprehensive record of external safety alerts received.
  • The provider had not put in place effective processes to ensure that, where patients consented, their registered GP was informed of the treatment provided by the service.
  • The provider had not developed any formal approach, or to risk assess the treatments they would provide to patients who did not consent to information being shared with their registered GP.
  • The provider had procured a package of generic policies; however, these were not sufficiently tailored to the service to be fit for purpose.
  • The provider had not put in place processes to assess, monitor and improve the quality of service; for example, by means of clinical audit.
  • The provider had not demonstrated that they had taken action in respect of areas highlighted for improvement during their previous CQC Inspection.

Following the inspection of 13 June 2019, the practice was placed into special measures.

We carried out an announced comprehensive inspection at Medicaoptima on 20 February 2020. Following this inspection, the key questions are rated as:

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

At this inspection we found that the practice had addressed all of the issues from the previous inspection.

We found that:

  • The service provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The service organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

13 Jun 19

During a routine inspection

This service is rated as Inadequate overall. (Previous inspection March 2018 – not rated. It was judged to be providing a service that was meeting the requirements, however there were some areas the provider should make improvements.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? - Inadequate

Are services caring? - Good

Are services responsive? - Good

Are services well-led? - Inadequate

We carried out an announced comprehensive inspection at Medicaoptima Ltd on 13 June 2019 as part of our inspection programme.

Medicaoptima Ltd provides a private general practice service, primarily to the local German-speaking population. The service is run by a single-handed GP, supported by a team of administrative staff.

As part of the inspection we asked the provider to distribute CQC comments cards to their patients during the two weeks preceding the inspection day. We received 15 comments cards, all of which were positive about the service provided.

Our key findings were:

  • Overall, the service had processes in place to keep patients safe; however, in some areas, such as safeguarding children and vulnerable adults, there was a lack of clear process and staff training.
  • There was limited evidence of activity to monitor the care provided in order to make improvements.
  • The provider had failed to put in place safe and effective arrangements to ensure that patients’ registered GPs were notified about the treatment provided. They had failed to establish an approach to providing treatment to patients who refused consent to information about their treatment being shared with their registered GP.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The service had failed to put in place systems to ensure good governance; policies and procedures were in place, but many were not fit for purpose. The practice had failed to address areas of weakness highlighted during our previous inspection.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Put in place systems and processes to ensure good governance.
  • Ensure care and treatment is provided in a safe way for service users.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

6 March 2018

During a routine inspection

We carried out an announced comprehensive inspection on 6 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; however, there were some areas where the provider should make improvements.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations; however, there were some areas where the provider should make improvements.

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; however, there were some areas where the provider should make improvements.

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.

Medicaoptima Ltd provides a private general practice service, primarily to the local German-speaking population. The service is run by a single-handed GP, supported by a team of administrative staff. Other services are provided from the building, including consultations with a psychiatrist, psychologist, nutritionist and Chinese Medicine practitioner.

The GP 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.

During the inspection we spoke to four patients, all of whom were happy with the service the received from the practice. We also reviewed all of the 21 CQC comments cards which had been completed by patients prior to the inspection and all of these contained positive feedback about the standard of care provided.

Our key findings were:

  • The practice had systems to manage risk so that safety incidents were less likely to happen; however, at the time of the inspection, in some areas these systems had not been formalised or risk-assessed; immediately following the inspection the practice provided evidence that a formal risk assessment in relation to Legionella and Infection Prevention and Control had been completed. When incidents did happen, the practice learned from them and improved their processes.
  • The practice ensured that care and treatment was delivered according to evidence based guidelines. There was some evidence of formal structured reviews of the effectiveness and appropriateness of the care provided; however, this required some further development.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a focus on continuous learning and improvement.

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

  • Review their current arrangements for checking the identity of patients and checking parental responsibility to ensure they are effective.
  • Continue to embed their newly introduced risk assessment process for managing the risk of infection and Legionella.
  • Review their current arrangements for sharing information with patients’ registered NHS GP to ensure that risks are mitigated.
  • Review their arrangements for documenting action taken in response to safety and medicines alerts.
  • Review their arrangements for monitoring and reviewing the quality of care provided.
  • Review their policies and procedures to ensure they contain current, practice-specific information.