Sculptedbydoctors

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.

This is the first inspection for this service since its registration with CQC. This key question has been rated as requires improvement.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had processes to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others. Records confirmed action was taken to ensure staff were trained to routinely follow all processes, including when these were updated.

The service lacked safe systems regarding accuracy of patient records relating to their medical history and the recording of consultations. Medical histories and current medicines did not match across the provider's own patient questionnaires. Consultation records were seen to be inaccurate. For example, one patient had multiple medical conditions listed on the patient questionnaire form, but was recorded as having no past medical history in the consultation notes. These omissions could pose a risk to patient safety. The provider offered home visits for people that requested this. The policy stated that visits would be subject to a risk assessment, but the provider could not evidence that risk assessments had been completed. The lack of risk assessments could pose risks to both staff and patients during intravenous (IV) infusion.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The safeguarding policy aligned with the local authority policy. All staff had completed the relevant safeguarding training.

The provider worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. People were advised on risks related to their condition and actions to take if their condition deteriorated.

The provider detected and controlled potential risks in the care environment within the clinic. They made sure equipment, facilities and technology supported the delivery of safe care. Contracts were in place to ensure the premises were maintained. Health and safety risk assessments within the clinic and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.

The service is run by a single doctor with support from a self-employed personal assistant. Disclosure and barring service (DBS) checks were carried out. We found training was up to date. The provider kept up to date with industry standards and developments in the field of intravenous (IV) vitamin infusion. Safe recruitment systems were in place.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The provider had a designated infection prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. When prescription-only medicines were administered intravenously, the provider did not record the batch number and expiry dates of the medicines used in patient records. This was against the provider's own policy and did not follow published best practice. Consultation records were not accurately completed. Conflicting information was recorded about the medicines patients were taking at the time of consultation and past medical history. No home risk assessments were provided on the day of inspection for IV medicine administration in patients’ homes this meant that the service was unable to demonstrate that environmental and patient‑specific risks had been identified, assessed, or mitigated prior to treatment. Medicines including controlled drugs were stored securely and at appropriate temperatures. The provider regularly checked the stock levels and expiry dates for all medicines, including emergency medicines.