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Medical Foundation London Good Also known as Freedom from Torture

Inspection Summary


Overall summary & rating

Good

Updated 19 July 2017

We rated The Medical Foundation London as good because:

  • Medical assessment rooms were equipped with the necessary equipment to carry out basic physical examinations. All areas were visibly clean and furnishings well maintained. There were good fire safety systems in place. Patients were seen promptly when referred to the doctor. Staff were familiar with the provider’s incident reporting procedures and were debriefed following incidents.

  • Staff completed comprehensive assessments in a timely manner. Care and treatment records were personalised, holistic and recovery orientated. This included good assessment of patient’s physical health needs. The service offered patients a wide range of psychological therapies recommended by The National Institute for Health and Care Excellence (NICE ) and support for employment, housing and benefits. There were good working relationships between the doctors and therapists. Doctors supported patients to make decisions and sought patient consent before conducting medical consultations.

  • Staff treated patients with kindness, dignity and respect. Patients were invited to give feedback on the service they received.

  • The service reviewed patients promptly at different stages of the referral pathway. Medical consultation rooms were sound-proofed and well-maintained. The service offered patients a variety of support and activity groups. The service had very good access to interpreters. Key patient information was provided in 13 different languages. Patients knew how to complain and information on how to complaint was available to them. The service handled complaints appropriately.

  • Staff enjoyed working at the service and were committed to providing good quality care and support to survivors of torture. The provider’s governance arrangements included checks that ensured doctors were appropriately qualified and competent. The service had a risk register in place and senior management reviewed it regularly. The service demonstrated its commitment to quality improvement and innovation.

However:

  • The service did not have adequate systems in place to safely assess and manage risk to patients and staff. Where patients had mental health issues, staff had not completed comprehensive risk assessments and these were not updated following recent incidents. Risk management plans did not include information, developed with patients, on what to do in a crisis. There were inadequate systems in place to monitor patient’s change in risk when they were waiting to be seen at intake panel or initial assessment.

  • The service had not always notified the Care Quality Commission (CQC) of notifiable incidents.

  • Not all staff had completed the appropriate mandatory training. The service did not have systems in place to monitor staff supervision and mandatory training rates.

  • The service had not kept up to date cleaning records for the building and examination equipment. The service had not completed an environmental risk assessment for the outdoor communal space, including the garden.

Inspection areas

Safe

Requires improvement

Updated 19 July 2017

We rated safe as requires improvement because:

  • The service did not have adequate systems in place to safely assess and manage risk to patients and staff. Where patients had mental health conditions, their risk assessments were not comprehensive and were not updated following recent incidents. Risk management plans did not include information, developed with patients, on what to do in a crisis.

  • There were no systems in place to monitor patient’s change in risk when they were waiting at different stages of the referral pathway.

  • Not all staff were up to date with the appropriate mandatory training. Staff had until the end of July 2017 to complete the training.

  • The service had not kept cleaning records for the building and examination equipment to demonstrate they were regularly cleaned. The service had not completed an environmental risk assessment for the outdoor communal space, including the garden.

  • The service had not always notified the CQC of notifiable incidents.

However:

  • Medical assessment rooms were equipped with the necessary equipment to carry out basic physical examinations.

  • All areas were visibly clean and furnishings well maintained.

  • There were good fire safety systems in place.

  • Patients were seen promptly when referred to the doctor, usually within their two-week target.

  • Staff were familiar with the provider’s incident reporting procedures. Staff were debriefed following incidents.

Effective

Good

Updated 19 July 2017

We rated effective as good because

:

  • Staff completed comprehensive assessments in a timely manner.

  • Care and treatment records were personalised, holistic and recovery orientated. This included good assessment of patient’s physical health needs.

  • The service offered patients a wide range of psychological therapies recommended by NICE and support for employment, housing and benefits.

  • There were good working relationships between the doctors and therapists.

  • Doctors supported patients to make decisions and sought patient consent before conducting medical consultations.

Caring

Good

Updated 19 July 2017

We rated caring as good because

:

  • Staff treated patients with kindness, dignity and respect. Patients told us that staff were helpful and they felt supported.

  • Patients were encouraged to be involved in the planning and delivery of their care.

  • Patients were able to feedback on the quality of the medical consultations they received. There was a user-engagement group for current and ex-patients to meet and feedback on the service.

Responsive

Good

Updated 19 July 2017

We rated responsive as good because:

  • The provider reviewed patients promptly at different stages of the referral pathway.

  • Medical consultation rooms were sound-proofed and well-maintained.

  • The service offered patients a variety of support and activity groups. The service had very good access to interpreters.

  • Key patient information was provided in 13 different languages.

  • Patients knew how to complain and information on how to complaint was available to them. The service handled complaints appropriately.

Well-led

Good

Updated 19 July 2017

We rated well-led as good because:

  • Staff enjoyed working at the service and were committed to providing good quality care and support to survivors of torture.

  • The service’s governance arrangement included checks that ensured doctors were appropriately qualified and competent.

  • The service had a risk register in place and senior management reviewed it regularly.

  • The service was going through a process of change to its clinical service model. The leadership team held focus groups for both staff and patients.

  • The service was committed to quality improvement and innovation.

  • The service had contributed to the NICE guidance for post-traumatic stress disorder.

  • The service carried out internal peer-reviews and doctors carried out peer-reviews of each other’s medical consultations.

However:

  • The service did not have systems in place to monitor staff supervision and mandatory training rates.

Checks on specific services

Community-based mental health services for adults of working age

Good

Updated 19 July 2017