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Archived: Harpal Clinic

Inspection Summary


Overall summary & rating

Updated 27 June 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 not providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was not always 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.

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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Harpal Clinic provides a bespoke service to patients of preventative medicine for non-debilitating medical issues (such as constant tiredness, recurrent mild headaches and low libido), help with more serious medical issues (such as hypothyroidism, polycystic ovarian syndrome and constant fatigue syndrome), as well as smoking cessation, help with reducing alcohol consumption, stress, and diet. Treatment is carried out using nutritional therapy and education and bioidentical hormone replacement therapy. Only people over the age of 18 were treated at the clinic.

The company director of Harpal Clinic 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.

Six people provided positive feedback about the service.

Our key findings were:

  • The service had not undertaken any clinical audits.
  • Patient consultations were undertaken before treatment commenced. This included the taking of a medical history and if any physical concerns identified, patients were referred to their GP before any further treatment.
  • The service had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service had a system to learn from them and improve.

  • The service used both the evidence based guidance of the National Institute for Clinical Excellence (NICE), and of the research undertaken in America
  • The practice prescribed some off-lable medicines (a medicine licenced used for a different indication to that for which it is prescribedlicensed). Medicines used outside of their licence have not been assessed for quality, safety and efficacy by the Medicines and Healthcare Products Regulatory Agency (MHRA) to the same standard as licensed medicines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Services were provided to meet the needs of patients.
  • Patient feedback for the services offered was consistently positive.
  • There were responsibilities, roles and systems of accountability to support governance and management.

There were areas where the provider must make improvements:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. For example the development of a programme of quality improvement, including clinical audit.
  • Ensure care and treatment is provided in a safe way to patients.

There were areas where the provider could make improvements:

  • Review systems for monitoring safety alerts.
Inspection areas

Safe

Updated 27 June 2018

We found that this service was not providing safe care in accordance with the relevant regulations.

  • There were systems in place for recording significant events and incidents.

  • The practice did not adequately monitor patients while undertaking treatments. For example no checks such as blood pressure monitoring and the recording of height and weight were carried out.

  • The practice had minimal contact with the patients GP except for in an emergency.

  • Safety alerts were being identified but there was no formal system for monitoring.

  • Staff demonstrated that they understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.

  • The service had adequate arrangements to respond to major incidents.

Effective

Updated 27 June 2018

We found that this service was not providing effective care in accordance with the relevant regulations.

  • There was no system for carrying out quality improvement activities, including clinical audits but there was some evidence of other quality improvement being carried out in relation to the improvements to consent forms.

  • Staff used both the evidence based guidance of the National Institute for Clinical Excellence (NICE), and of the research undertaken in America.

  • Staff had the skills and knowledge to deliver effective care and treatment.

  • Staff had appraisals with personal development plans.

Caring

Updated 27 June 2018

We found that this service was providing caring services in accordance with

the relevant regulations.

  • Feedback from patients was positive and indicated that the service was caring and that patients were listened to and supported.

  • The provider had systems in place to engage with patients and seek feedback using a survey handed to all patients after their appointment.

  • Systems were in place to ensure that patients’ privacy and dignity were respected.

Responsive

Updated 27 June 2018

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

  • The understood its patient profile and used this understanding to meet the needs of users.

  • Treatment costs were clearly laid out and explained in detail before treatment commenced.

  • Patient feedback indicated they found it easy to make an appointment, with most appointments the same day.

  • Facilities were not suitable to patients with walking difficulties; however the practice had an agreement with a local clinic to refer patients on.

  • Patient feedback was encouraged and used to make improvements. Information about how to complain was available and complaints were acted upon, in line with the provider policy.

Well-led

Updated 27 June 2018

We found that this service was not providing well-led care in accordance with the relevant regulations.

  • The provider had a clear vision and strategy and there was evidence of good leadership within the service.

  • There were systems and processes in place to govern activities. Some systems were in need of further development, such as responding to alerts and undertaking clinical audit.

  • Risks were assessed and managed.

  • There was a culture which was open and fostered improvement.

  • The provider took steps to engage with their patient population and adapted the service in response to feedback.