Archived: Lowedges Clinic Also known as Dr J Revill

We carried out an announced comprehensive inspection on 26 July 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Following this inspection we took enforcement action to cancel the registration of the provider. This means the provider will no longer be able to operate the service.

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 not providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was not 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.

Background

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.

Lowedges Clinic provides treatment to adults with a history of alcohol and opiate substance abuse. The clinic offers insertion of the naltrexone implant under the skin during a minor surgical procedure using local anesthetic. It does not offer a detoxification service and does not see people under the age of 18. The clinic does not employ any staff and is owned by a retired GP who is supported by three volunteers who assist with the procedure and perform administrative duties. Patients must come with a carer who stays with them when the procedure is carried out.

The provider, Dr John Revill, is registered with the Care Quality Commission to provide services at Lowedges Clinic, 7 Low Edges, Chesterfield Road , Sheffield, S8 8LW. The clinic is located between Sheffield and Chesterfield in a converted residential building. It consists of a reception/waiting room and treatment room downstairs with an accessible toilet to the rear of the building, in the back yard. There is a consulting room and treatment room on the first floor accessed via a steep stair case. There is free on-road parking.

The clinic holds a list of registered patients who are self referred to the service. The clinic is available to patients who reside in England and from other countries who require the services.

As part of our inspection we reviewed seven Care Quality Commission comment cards where patients shared their views and experiences of the service. All of the seven comment cards we received were positive about the service experienced. Patients said the clinic offered an excellent service and staff were sensitive, professional, very caring and treated them with dignity and respect.

The clinic is open on Tuesdays from 12 noon to 6pm. Treatment is by appointment only and patients can contact the doctor via a telephone messaging service at other times. The provider is not required to offer an out of hours service and those who need emergency medical assistance outside of the clinic opening hours are requested to seek assistance from alternative services such as their own GP, the NHS 111 telephone service or accident and emergency.

Our key findings were:

• The clinic did not have safety systems, processes or procedures to keep patients safe and reduce the risk of avoidable harm or abuse. The doctor and volunteers had not undertaken adequate safeguarding training. The were no systems in place to mitigate the risks of the health and safety and welfare of patients and others. 
• Patients' care and treatment did not reflect current evidence-based guidance, standards, practice or technology. The information needed to plan and deliver effective care and treatment and support was not available at the right time and was not appropriately shared with other care providers.
• Volunteers who supported the doctor were not adequately inducted into or trained for their role.
• Services were not planned or delivered in a way that met patients' needs.
• The delivery of high quality care is not assured by the leadership and governance of the clinic.

We identified regulations that were not being met and the provider must: 

• Ensure care and treatment is provided in a safe way to patients.
• Ensure patients are protected from abuse and improper treatment.
• 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.