We carried out an announced comprehensive inspection on 25 April 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 not providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this service was not 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.
Background
La Maison Médical is private doctors’ clinic based in South Kensington, in the south-west part of central London. The service provides services to the whole community. A large number of patients registered with the service have French as either their primary or second language. The service provides patients with access to a number of clinical specialists, a number of which are located primarily in France, but are registered to practice medicine in the UK. These specialists have experience in a number of areas including general medicine, dermatology, gynaecology, urology, as well as providing physiological and lifestyle assessments. These clinical specialists are contracted to work at the service when their services are required by a registered patient.
The services offered by La Maison Médicale are provided to adults and children as private patients.
The service is situated in a rented basement floor of a terraced converted building, which has consultation/treatment rooms, a patient waiting area, patient toilets and rooms for administrative staff.
The nominated individual (the point of contact between the Commission and 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.
La Maison Médicale is registered to conduct the following regulated activities under the Health and Social Care Act 2008:-
- Treatment of disease, disorder and injury
- Diagnostic and screening procedures
Prior to our visit, the service was provided with feedback cards for their patients to complete with their views about the service by completing comments cards. Seventeen feedback cards were completed prior or during our inspection of the service.
Our key findings were:
- Staff had been trained with the skills and knowledge to deliver care and treatment.
- There was no evidence of clinical staff meetings and/or opportunities to share clinical learning/knowledge.
- The service had systems to keep people safe and safeguarded from abuse, however these were not clearly defined.
- The service did not have adequate medicines in place in the event of a medical emergency at the service.
- Information about services and how to complain was available. Information about the range of services and fees were available.
- The service had not conducted a recent review of service policies and procedures.
- The service had good facilities and was (with the exception of emergency medicines) equipped to treat patients.
- There was no oversight or quality assurance of the work of clinical work conducted at the service.
- The service kept patient information secure.
- The service did not conduct fire drills and did not have a trained fire warden on site
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients
- 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
The areas where the provider could make improvements and should:-
- Review arrangements for the provision of training, specifically in relation to infection control, information governance and Mental Capacity Act 2005 training.
- Review arrangements regarding written guidance relating to the continuation of business in the event that the service could not operate from it registered address.
- Review arrangements to obtain up-to-date an Legionella testing certificate.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice