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Harmony Medical Diet Clinic in Wood Green Requires improvement

Reports


Inspection carried out on 12 November 2019

During a routine inspection

This service is rated as Requires improvement overall. The previous inspection in January 2017 was not rated.

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? – Requires improvement

We carried out an announced comprehensive at Harmony Medical Diet Clinic in Wood Green as part of our inspection programme.

Harmony Medical Diet Clinic provides weight loss services for adults, including the provision of medicines for the purposes of weight loss under a doctor’s supervision.

The doctor 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.

11 people provided feedback about the service and their comments were all positive. They told us it was a friendly, effective service.

Our key findings were:

  • Patient feedback was positive and they found the service effective
  • Patient leaflets were available in a range of languages and in pictorial form
  • Processes to ensure the proper and safe management of medicines were not effective
  • Equipment had not been calibrated
  • Processes to assess and monitor risks and quality of service were not effective

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.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review the need for chaperones and, if the service is offered, ensure suitably trained and competent staff are available.
  • Review the policy for disposal of medicines to ensure it is in line with controlled drugs regulations and followed in practice.
  • Consider including a question on the quality of clinical care provided when asking patients for feedback
  • Review the arrangements for ensuring that the service only treats patients aged 18 and over
  • Review the arrangements for the retention of medical records if the provider ceases trading, in line with Department of Health guidance.
  • Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 23 January 2017

During an inspection looking at part of the service

We carried out a focused inspection on 23 January 2017 to ask the service the following key question: Is the service well-led?

Our findings:

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

Inspection carried out on 15/12/2015

During a routine inspection

We carried out an announced comprehensive inspection on 15/12/2015 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 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.

Background

Harmony Diet Clinic provides a weight reduction service and provides medication and dietary advice to the patients accessing the service. The service operates from a consultation room at the back of a high street Pharmacy in Wood Green, North London. The clinic runs on Mondays and Tuesday between 9.30am and 4.30pm, and offers a walk in service.

The clinic is run by one doctor who is supported by the registered manager who is also a doctor. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There are two other locations of this service that are also run by the same provider in Bedford and Coventry. The registered manager provides supervision and support to all practitioners working across the locations.

The patients that we spoke to on the day of the inspection said that they felt that the clinic offered an excellent service and staff were efficient, helpful and caring and treated them with dignity and respect.

Inspection carried out on 20 November 2012

During a routine inspection

We talked to one person who used the service. They said that they had been recommended to the doctor. They told us that they completed a medical form and were given a letter to take to their GP describing the consultation. They said that they found the consultation helpful and that they received a prescription for medicines and were going to come back in a week�s time to be weighed and to see if the medicines were of benefit.

We found that people were supplied with information about the medications the clinic was using and signed to consent to their use. The information noted that the medications were not recommended by NICE (National Institute for Health and Clinical Excellence) for the treatment and management of obesity.

We found that the doctor was treating people with a BMI (body mass index) over 23. NICE Guidance states that only patients with a BMI of over 28 should be treated, but there was evidence the doctor had consulted with the General Medical Council to discuss the rationale of treating a lower body mass index.

Inspection carried out on 26 July 2011

During a routine inspection

People told us they were satisfied overall with their service and would recommend the service to others. However our review found that people were not given sufficient information about their medicines to fully inform their decision making.

Reports under our old system of regulation (including those from before CQC was created)