This service is rated as
Inadequate
overall.
The key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Inadequate
We carried out an announced comprehensive inspection of London Dermatology Centre on 30 June 2022. This was the first CQC inspection of this location under the current CQC inspection methodology, although the service had been inspected under CQCs previous methodology in October 2013 at which time it was compliant with CQC regulations.
The registered manager is the service manager at the location. 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 did not have systems in place to ensure that risk factors had been adequately analysed and mitigated.
- Some staff that we spoke to at the service were not aware of safety protocols, and were not aware of their requirements regarding safeguarding.
- The service did not have all emergency medicines and equipment required for a service of its type.
- Patients received effective care and treatment that met their needs.
- The services clinical record system did not have an easy to use audit facility, and the service had not completed audits on specific treatments. Clinical oversight of clinicians at the service was unclear. The clinical record system could not flag specific relevant details, such as any patients on the safeguarding register, and patient records were in some cases noted to be incomplete or unclear.
- Staff training was incomplete, and the service did not have sufficient mechanisms in place to assure that the training of any staff was monitored.
- Parent identification was not sought when children were treated, so the service could not be assured that consent could be provided.
- 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.
- Governance and risk assessment protocols at the service were not well developed.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure that care and treatment is provided in a safe way to patients.
- Ensure systems and processes are established and operated effectively to ensure compliance with the requirements of good governance.
- Ensure systems and processes are established and operated effectively to ensure compliance with the requirements of good staffing.
The areas where the provider should make improvements are:
- Improve the way complaints are being adequately captured and managed.
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