Background to this inspection
Updated
29 August 2019
The registered provider, Smart Medical Clinics Limited, provides private general practice services from two locations in London: The Smart Clinics Wandsworth and The Smart Clinics Brompton Cross. General dental services are also provided at The Smart Clinics Brompton Cross. This inspection concerned only The Smart Clinics Brompton Cross, located at 13 Crescent Place, London SW3 2EA.
The service is in a commercial property, where it occupies the first floor. There is lift access between floors in the building, making it accessible to wheelchair and pushchair users. There are patient toilets, including one adapted for wheelchair users, and baby changing facilities available. One side of the premises is assigned to their dental service and the other their GP service. Each side of the service has a reception and waiting area, clinical consultation and treatment rooms, storage areas and administration offices.
Services are available to any fee-paying patient. Services can be accessed through an individual, joint or family membership plan or on a pay per use basis.
Services are available by appointment only on Monday to Thursday from 8am to 7.30pm, on Friday from 8am to 6:30pm and on Saturday from 9am to 12pm.
The service is led by the medical director who is also one of six GPs in the clinical team. The clinical team is supported by two service managers (who are also the registered managers) and a team of administrative staff members. Those staff who are required to register with a professional body were registered with a licence to practice.
The service has two CQC registered managers who work jointly across both provider locations in service management roles. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.
The service is registered with the CQC to provide the regulated activities of diagnostic and screening procedures, family planning, surgical procedures and treatment of disease, disorder or injury.
Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew. During our visit we:
- Spoke with a range of clinical and non-clinical staff including GPs, service managers and administrative staff.
- Reviewed an anonymised sample of the personal care or treatment records of patients.
- Reviewed service policies, procedures and other relevant documentation.
- Inspected the premises and equipment used by the service.
- Reviewed CQC comment cards completed by service users.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
29 August 2019
This service is rated as Good overall. (Previous inspection 05 2018)
The key questions are rated as:
Are services safe? – Requires improvement
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 The Smart Clinics Brompton Cross on 19 June 2019 as part of our inspection programme, and to rate the independent doctors aspect of the service for the first time. General dental services are also provided at The Smart Clinics Brompton Cross, which we also inspected on the same day as this inspection, but which are reported on separately as that aspect of the service is not being rated.
The two service managers are the registered managers. One of the registered managers is currently on long term absence. 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.
Fifteen people provided feedback about the service by completing comments cards, which we made available in the practice two weeks prior to our inspection and on the day of our inspection itself. Their comments were all positive about their care and treatment experiences, reception staff and clinicians being helpful and treating them with care. We also received four patient feedback responses through the Share Your Experience area of our website about The Smart Clinics Brompton Cross since this inspection was announced. These were also all positive and had similar themes to the comments cards completed at the service, such as a good care and treatment, a prompt and convenient service, and that the service was provided in a clean environment.
Our key findings were:
- There were arrangements to keep people safe and safeguarded from abuse. However, some areas need further review; particularly management of medicines, staff training, infection prevention and control arrangements and clinical waste management.
- The service undertook clinical and non-clinical quality improvement activities in the independent doctors’ service.
- Patient feedback we received indicated people were totally satisfied with their care and treatment experiences and raised no concerns or complaints about the independent doctors service.
- We found that complaints were appropriately managed.
- The facilities and premises were appropriate for the services offered.
- There were clear responsibilities, roles and systems of accountability to support good management.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
- Records checks of medicines and equipment for treating medical emergencies to provide assurances they are fit for purpose.
- Provide appropriate notifications and information to people using and accessing the service for the use of closed-circuit television (CCTV) in common areas.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care