The Cliffs Chiropractic Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We scored the service as 2. The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff involved patients in their care. Staff personalized care to the individual and care plans were created from the imaging data to support patients. Patients we spoke to told us they were listened to and staff engaged with them in decisions about their care. Patients said staff asked for their thoughts and opinions of the service.

Leaders told us there were multilingual and bilingual staff available to support patients whose first language was not English.

Staff checked and documented pregnancy status. We also observed posters in the radiographer’s booth with prompts for checking pregnancy status.

Staff told us they asked patients about their general health and wellbeing in order to effectively explore patient concerns.

The services provided numerous leaflets in the clinic on healthy eating, pregnancy advice, sports and whiplash injuries.

The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Quality assurance audits on x-rays were regularly conducted to improve exposure standards, and these were used in accountability processes with the radiation protection adviser.

The Bournemouth questionnaire and the Patient Global Impression of Change (PGIC) forms were used to gather individual patient feedback and outcome measures. The Bournemouth questionnaire is a comprehensive, multidimensional core outcome tool to assess outcomes of care in routine clinical settings. The PGIC evaluated all aspects of patients’ health and captured whether improvements or declines had occurred in clinical status.

Staff and leaders told us they were aware of recent changes to national guidance relating to dose levels based on a patient’s weight. We found evidence that the service communicated with the physics expert about dosage levels in line with national guidance.

However, leaders told us that patient-reported outcome measure surveys were conducted by the service using questionnaires, which consistently produced positive results.

The service did not check that guidance and policies on which care and treatment were based were current or aligned with best practice. Staff followed out of date policies to plan and deliver care. Leaders had not reviewed these policies for several years. As an example, the service had a copy of The Ionising Radiation (Medical Exposure) Regulations 2000 but this was outdated. The Ionising Radiation (Medical Exposure) Regulations were last updated in 2024. We also saw a training policy procedure dated April 2022 and a clinical audit policy dated November 2020.

The service did not check that guidance and policies on which care and treatment were based were current or aligned with best practice. Staff followed out of date policies to plan and deliver care. Leaders had not reviewed these policies for several years. As an example, the service had a copy of The Ionising Radiation (Medical Exposure) Regulations 2000 but this was outdated. The Ionising Radiation (Medical Exposure) Regulations were last updated in 2024. We also saw a training policy procedure dated April 2022 and a clinical audit policy dated November 2020. This was escalated to the service lead, who stated that a review of all policies and guidance would be undertaken in April 2026.

After the assessment we were told the provider had changed from using films to a detector in September 2024. The provider had a new tube and exposure panel in 2025. Leaders stated that quality assurance checks had been updated and adjusted since this new equipment. However, we were not provided with any additional evidence to support this.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We were unable to see staff working with patients on the day of the inspection as there were no scheduled diagnostic appointments. However, staff said they enjoyed working in the service and had worked for the provider for over 5 years.

Staff said learning was shared in team meetings and all staff were encouraged to share knowledge with the wider team.

Staff worked as a multidisciplinary team which included radiographers and other health care professionals to deliver good care. The chiropractors were trained to carry out x-rays. Staff told us there was joint working between chiropractors, radiographers and the massage therapist was initiated when necessary.

The service did not receive direct referrals from external providers, to provide treatment for patients. Chiropractic staff referred their own patients for x-rays in line with their treatment plan.

Staff told us attendance at monthly team meetings was confirmed by text, or staff were given access to full minutes if they could not attend. The lead radiographer was able to provide minutes and discuss recent meetings.

Staff knew to call 999 if a patient required emergency care. However, there was a lack of governance including polices around a deteriorating patient.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff told us practical support and advice were provided to help patients lead healthier lives. The service provided information promoting healthy lifestyles for patients. Staff told us they used professional knowledge to provide self-help tools and resource materials.

Staff offered hot drinks on arrival, and patients also had access to a water machine.

The service did not provide medicines or pain relief; however, patients’ pain during x-ray procedures was responded to by staff. Repositioning advice was offered to alleviate discomfort during investigations. However, we observed expired supplements in the reception area and back-office area. This was escalated to staff on the day, and supplements were appropriately disposed of immediately. Some supplements in the reception area was for display purposes only.

The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Many of the services policies were outdated by several years. This meant there was a risk that care delivered was not always reflective of current national guidance. We escalated this to the registered provider. Some updated policies were received post inspection. For example, the infection control policy had not been reviewed since 2011, despite the availability of more recent guidance from multiple sources. We escalated this to the registered provider and we were told the service would send these to us post inspection. Some updated policies were received post inspection.

However, the service logged and audited the amount of radiation patients were exposed to. This ensured diagnostic reference levels were adopted and used to support safe and appropriate x-ray exposures. Staff undertook these audits every 6 months. Documented discussions were seen regarding these audits, with amendments to practice made when excess exposure had been identified. We observed that the most recent radiation exposure audit was undertaken in 2025 and levels were reported to be in range.

We reviewed evidence of a recent incident of accidental over-exposure and this was investigated appropriately by the provider.

Staff maintained records for x-rays taken. This included the type of x-ray, the exposure level, and patient details such as weight and measurements of the area imaged.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff supported patients to make informed decisions about their care and treatment and the service had a consent policy. Consent forms included a statement confirming that staff had explained the reasons for the x-ray, and female patients confirmed their pregnancy status and risks in pregnancy had been explained. However, the consent policy was out of date and had not been reviewed since 2019.

Staff were able to obtain consent for care and treatment. Staff assessed patients’ capacity to consent and they were trained in mental capacity. However, on the day of the inspection we found mental capacity training certificates dated from 2019. This meant that the service could not be assured that assessments were carried out in line with up to date legislation and guidance.

Staff clearly recorded consent in patient records; records checked on the day all contained consent documentation. Staff gained and documented parental consent for patients under 16 years.

Staff ensured patients were consented to treatment based on full information.