28 June 2019
During a routine inspection
This service is rated as Good overall . (Previous inspection July 2018 was not rated)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Nippon Club North Clinic on 28 June 2019 as part of our inspection programme. The inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 so that an overall rating could be given. At this inspection we also followed up a breach of regulation 17 Good governance which was identified at our previous inspection on 12 July 2018.
Nippon Club North Clinic is located within the Hospital of St John and St Elizabeth in St John’s Wood in West London. The clinic provides a primary care service for Japanese patients. The doctors are restricted by the terms of their licence to practice in the UK and must only provide care to Japanese nationals.
The secretary general of Nippon Club Limited is the acting manager for the service. The service does not currently have a registered manager for the location but this is in process. (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.)
We received comment cards completed by patients in the days leading up to the inspection and interviewed patients on the day of the inspection. In total, ten patients contributed their views which were positive about the service and described the service as kind and caring. Several patients commented that they found it very helpful to be able to access a Japanese-speaking service.
Nippon Club North Clinic is registered to provide the regulated activities of diagnostic and screening services; and, treatment of disease, disorder or injury.
Our key findings were:
- Systems were in place to protect people from avoidable harm and abuse.
- When mistakes occurred, lessons were learned and action was taken to minimise the potential for recurrence. Staff understood their responsibilities under the duty of candour.
- Staff were aware of current evidence-based guidance.
- Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
- Patient feedback indicated that patients were very positive about the service.
- The service was accessible to patients including outside normal working and school hours.
- Information about services and how to complain was available.
- There was clear leadership, staff felt supported and the staff team worked well together.
- There was a vision to provide a high quality, culturally appropriate service for Japanese patients living in London.
- The service had systems in place to monitor and improve the quality of service provision.
- There was scope to increase the scope and impact of clinical quality improvement activity.
The areas where the provider should make improvements are:
- Review and assess the training needs of administrative staff, particularly those with face to face contact with patients, in relation to sepsis and other ‘red flag’ symptoms.
- Review the scope to improve evidence-based prescribing of antibiotics.
- Review the quality improvement programme with a view to increasing the scope and impact of clinical audit and other improvement work.
Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care