Medicaoptima Ltd

Updated 27 March 2020

Medicaoptima Ltd provides a private general practice service in Richmond, South West London, primarily to the local German-speaking population. It also serves the nearby German School London. The service is run by a single 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; however, these services do not fall within the scope of registration and therefore were not looked at as part of the inspection.

The practice provides appointments Monday to Friday. The GP also provides some home visits to the practice population, which at the time of this inspection was approximately 800 patients.

We carried out this comprehensive 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.

Before visiting, we reviewed a range of information we hold about the service. During our visit we:

• Spoke with the GP (who is also the registered manager) and a member of the administrative team.
• Reviewed a sample of the personal care or treatment records of patients.
• Reviewed service policies, procedures and other relevant documentation.
• Inspected the premises and equipment in use.

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 27 March 2020

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