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Archived: Medecins du Monde UK (Doctors of the World)

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Updated 27 April 2018

We carried out an announced comprehensive inspection on 28 February 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.

Are services effective?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing safe 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.

Medecins du Monde UK is a registered charity and is part of the Medecins du Monde (Doctors of the World) wider network which is an international humanitarian organisation that has clinics in developed and developing countries. Since 2006, services are provided to patients from the ground floor of the Praxis Community Projects Centre in a church building which houses a range of other services committed to empowering vulnerable migrants. The Doctors of the World UK programme model is designed to support and offer primary care, health and social advice to excluded people including sex workers, asylum seekers, undocumented migrants and homeless people. The service can be accessed by local buses and is within easy access of Bethnal Green Underground Station. The service is registered with the Care Quality Commission to provide the regulated activity of Diagnostic and screening activities from: Praxis, Pott Street, London, E2 OEF.

The main service provided from the clinic is health advocacy to ensure people can access mainstream health-care, with referrals and signposting to other health and social care providers, including antenatal care and mental health counselling. Volunteer GPs and nurses carried out health checks, including screening for STIs, contraception counselling and provision, and prescription from a limited formulary.  They also facilitate monthly Tuberculosis (TB) and sexual health screenings in partnership with two London hospitals. Employed staff at local level comprises of a full time Programme Manager, programme staff and volunteer manager, clinic and helpline officer, health advisor, policy and advocacy managers, GP champions and campaign lead. Since the UK programme started in 2006, Medecins du Monde UK have provided help to 13,362 vulnerable migrants across their UK clinics. Patients who require further investigations or any additional support are signposted on to other services such as NHS GPs and A&E.

The service’s opening hours are Monday, Wednesday and Friday 11am to 3pm. Appointments are available between 11am and 2pm with limited availability for walk in’s on the day. The appointment and advice lines are open Monday to Friday between 10am and 12midday; outside of these hours patients were advised to email the service.

The programme manager 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.

Our key findings were:

  • There were effective systems in place for recording, investigating and learning from incidents.
  • Care and treatment was provided in line with evidence based guidance.
  • Staff worked with other health professionals and other organisations where appropriate and supported patients to access other healthcare services.
  • The provider participated in improvement activity such as clinical audit and other benchmarking to support service improvements.
  • Care and treatment was planned and delivered to suit the needs of the patients they saw.
  • Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005. This was underpinned by a standing operating procedure.
  • The service had a complaints policy in place and information about how to make a complaint was available for patients.
  • There was a clear organisational structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
  • Feedback from patients about the care and treatment they received was very positive.

There were areas where the provider should make improvements:

  • Review and update the business continuity plan.
  • Continue to review the service’s fire arrangement to ensure risk assessments are undertaken as per recommendations.
  • Review and consider having onsite emergency equipment such as a defibrillator and oxygen.
  • Review the emergency medicine risk assessment and consider detailing which emergency medicines are unsuitable to stock.
Inspection areas

Safe

Updated 27 April 2018

We found that this service was providing safe care in accordance with the relevant regulations.

  • The service had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguard them from abuse.

  • All staff had received safeguarding training appropriate for their role. All staff had access to referral pathways.

  • The service undertook appropriate recruitment checks for all staff including clinical and non-clinical volunteers.

  • There was an induction system for volunteer staff tailored to their role.

  • The service had a business continuity plan, however this needed updating to be fit for purpose.

Effective

Updated 27 April 2018

We found that this service was providing effective care in accordance with the relevant regulations.

  • Patients’ needs were assessed and care was planned and delivered in line with best practice guidance.

  • Systems were in place to ensure the security and safe access of patient records by volunteers.

  • Staff were aware of most current evidence based guidance.

  • The service had systems to keep all clinical staff up to date.

  • The service monitored patient outcomes.

Caring

Updated 27 April 2018

We found that this service was providing caring services in accordance with the relevant regulations.

  • CQC comment cards completed by patients were very positive about the standard of care they received.

  • The service provided facilities to help patients be involved in decisions about their care.

  • Curtains were provided in consulting rooms to maintain patients’ privacy and dignity during examinations, investigations and treatments.

  • The services 2017 in house feedback survey results indicated that patients felt their dignity was respected during examinations with the doctor. This was echoed by patients we spoke with on the day of inspection.

  • Information for patients about the services available was accessible.

  • We saw staff treated patients with kindness and respect, and tried their outmost to maintain patient and information confidentiality.

Responsive

Updated 27 April 2018

We found that this service was providing responsive care in accordance with the relevant regulations.

  • Translation and interpreting services were available for those who did not have English as a first language.

  • Appointments could be booked over the telephone and they offered a limited number of walk-in appointments.

  • The service had a complaints policy in place and information about how to make a complaint was available for patients.

  • The service employed female and male volunteer clinicians.

  • The service worked in partnership with other local services to deliver care.

  • Patients were signposted to other services, including counselling, housing and specialised non-government organisations (NGOs).

Well-led

Updated 27 April 2018

We found that this service was providing well-led care in accordance with the relevant regulations.

  • There was a clear leadership structure and staff and volunteers felt supported by management.

  • The provider was aware of and complied with the requirements of the duty of candour.

  • The service had policies and procedures to govern day to day activities.

  • The service had systems and processes in place which ensured patients’ data remained confidential and secured at all times.

  • The service engaged with the volunteers and satisfaction rate from the most recent survey showed staff felt supported. Staff/volunteers we spoke with on the day expressed pride in working for the organisation.