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Inspection carried out on 25 September 2014

During a routine inspection

A single inspector carried out the inspection. The focus of the visit was to answer five key questions: is the service safe, effective, caring, responsive and well-led.

Below is a summary of what we found. The summary describes what people who used the service, and staff, told us. Also what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

Patients felt safe using the service and were confident about the equipment used as well as the competence of the staff. Staff had opportunities for professional development and were supervised to ensure they had the required level of skill before working more independently.

Clinical staff had regular appraisal and feedback was sought from clinicians primary employer, which was usually an NHS Trust, to ensure they had the necessary skills and qualifications to carry out consultations and treatment at the clinic.

Staff demonstrated a good understanding of their responsibilities in relation to safeguarding.

There were arrangements in place for the safe storage and disposal of medical equipment.

We found the service to be safe.

Is the service effective?

We saw that patients consent was obtained prior to any treatments and people told us they were fully involved in all aspects of their care. Patients were wholly complimentary about their care and treatment and many had chosen to return to the clinic as they had experienced effective and high quality care previously.

We found the service to be effective.

Is the service caring?

We observed staff talk to people in a friendly and courteous way. People using the service described staff as "fantastic", "skilled" and having a "good bedside manner". We saw staff checking patients were comfortable and offering reassurance during a particular procedure.

Staff demonstrated a good understanding of what privacy and dignity meant and we saw the environment was conducive to meeting patients privacy and dignity needs.

Staff appeared motivated to deliver high quality care and valued having time to spend with patients and not make them feel rushed.

We found the service to be caring.

Is the service responsive?

Appointments depended upon the availability of clinicians but we saw they were available throughout the day time and evenings. Patients told us they appreciated that they had been offered very prompt appointments, often within a couple of days. Results were also conveyed to patients in a very prompt way.

We saw the provider was responsive to feedback, and actions identified as part of the audit process had been completed.

We found the service to be responsive

Is the service well-led?

Staff told us their managers were available and staff, and patients felt able to raise any concerns or ideas.

There were quality assurance processes in place to monitor the environment.

We found the service to be well-led.

Inspection carried out on 24 September 2013

During a routine inspection

We spoke with three people who use the service and two relatives at our inspection. All of the people we spoke with were complimentary about the clinic. One patient stated, �This is my third visit to The Bridge Clinic and it is totally first class. They are professional with my care and I am seen on time�.

People we spoke with told us their care information was transferred to other registered providers when necessary. They said this helped with the continuity of their care between different care professionals who provided their treatment.

People we spoke with were satisfied with the safety and suitability of the premises. People told us there was plenty of parking, that the premises made them feel relaxed prior to procedures and that the grounds were �immaculate�.

Appropriate checks were undertaken before staff began work. This was confirmed in staff recruitment records we looked at.

People we spoke with were aware of how they could make a complaint. We spoke with three people who told us they had no complaints about the service. They felt confident they could raise any concerns with The Bridge Clinic.

Inspection carried out on 28 November 2012

During a routine inspection

On the day of our visit, people who used the service unreservedly praised the professionalism and efficiency of the staff at the clinic. They said they were provided with information about their treatment and they felt comfortable asking for more information if they needed it. We were told staff treated people professionally and with respect. People felt confident they were provided a service by experienced and qualified doctors and nurses. They also commented on the cleanliness of the clinic's facilities, with one person stating the rooms were "immaculate".

We found people using the service were provided with appropriate care to meet their needs. Care and treatment were provided by trained and competent staff and arrangements were in place for clinical supervision. The facilities were clean and infection prevention and control measures were in place.

There were systems for monitoring the quality and safety of services provided to people which included audits and surveys. Systems for collecting feedback from patients, monitoring medical safety alerts, and identifying risks to people were also in place. Where improvements to services were required, these were made.

Inspection carried out on 21 March 2012

During a routine inspection

The people we spoke with said they received excellent explanation of their care and treatment at The Bridge Clinic including the options available to them and any risks and benefits involved. They said they were able to ask questions and take time to consider their decisions before proceeding. The said they were asked to give consent before any procedure. People told us that information and advice was provided verbally and in the form of leaflets and DVDs. They felt their privacy was well respected at the service.

People told us they had been asked about their medical history including any allergies they experienced or medication they were taking and this was reviewed on each visit. Those that experienced an allergy said the doctor displayed a good awareness of this.

People said they felt comfortable with the way they were treated at The Bridge Clinic by friendly and helpful staff. They said they had a high level of confidence in the doctors� competence and felt the other staff at the clinic were professional and well qualified to carry out their roles.

The people we spoke with said they had no cause to raise a concern about the service. They said they felt confident and comfortable approaching their doctor or the manager with any concerns if they needed to. Those that didn�t know about the formal procedure for raising a concern or surveys to feedback about their experiences said this was because they had no interest in doing so. One person said she had seen the concerns procedure displayed throughout the service and surveys were available for her to complete.

One person said of his experience at The Bridge Clinic: �I�ve become increasingly impressed with the scope of the service, the way it�s organised and the care and attention of the staff. It�s terribly good�. Another person said: �My experience has been 100%. I�ve never been a patient and wasn�t happy at having to be one, but they�ve all been brilliant�.

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