Archived: Litfield House Medical Centre

Updated 18 July 2019

The registered provider is the National Centre for Integrative Medicine based at Rodney House, Clifton Down Road, Bristol BS8 4AL which delivers a Homeopathic Service.

The provider has the one registered location at:

Litfield House

1 Litfield Place

Clifton Down

Bristol

Which we visited as part of the inspection.

There are additional sites at the Vine Surgery, Street, Somerset and The Practice Rooms, 26 Upper Borough Walls, Bath which were not visited.

We inspected the National Centre for Integrative Medicine (NCIM) at Litfield House Medical Centre on 15 May 2019. NCIM provides services from a rented room at Litfield House Medical Centre. The medical centre provides reception staff as part of the room rental fee. The centre also employs a business manager to ensure that all staff at the building are trained and when necessary have a disclosure and barring service check (DBS) and that the facilities are maintained. The service is available to the whole population including children.

The provider’s statement of purpose identifies the provision of medical homeopathy. There is a team of five medical doctors who deliver the service. All of the team are Medical Homeopathic Doctors and members of the Faculty of Homeopathy. This is the registering body for statutorily regulated healthcare professionals who use Homeopathy in their clinical practice. The doctors are also fully trained in conventional and complementary medicine and are registered with the General Medical Council, GMC). This means they consider all medical avenues for their patients, and apply their knowledge using an Integrative Medicine model.

The core hours for the service are 9am – 6pm Monday to Friday. There is no urgent care provision.

Prior to the inspection we received the pre-inspection information for the provider and reviewed the information available on their website.

During our visit we:

• Spoke with the provider and registered manager.
• Observed how patients were being cared for.
• Reviewed records and documents.
• Reviewed comment cards where patients and members of the public shared their views and experiences of the service.

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 18 July 2019

This service is rated as Requires improvement overall.

The key questions are rated as:

• Are services safe? – Requires improvement
• Are services effective? – Requires improvement
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at Litfield House Medical Centre as part of our inspection programme to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

This service provides Homeopathic Services in the South West of England. The team of Medical Homeopathic Doctors are all members of the Faculty of Homeopathy. This is the registering body for statutorily regulated healthcare professionals who use Homeopathy in their clinical practice. The doctors are also fully trained in conventional and complementary medicine and we reregistered with the General Medical Council (GMC).

This service, the National Centre for Integrative Medicines(NCIM), is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At the NCIM services are provided to patients under arrangements made by their employer with whom the servicer user holds a policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, at NCIM, we were only able to inspect the services which are not arranged for patients by their employers with whom the patient holds such a policy.

The clinical lead Dr Elizabeth Thompson 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 Act2008 and associated Regulations about how the service is run.

As part of our inspection we asked for Care Quality Commission comment cards to be completed by patients prior to our inspection. We received feedback about the service from 17 patients. All the respondents commented positively about their experiences, stating they received a high level of service and were treated with care and consideration.

Our key findings were:

• Risks to patients were well managed for example, there were effective systems in place to reduce the risk and spread of infection.
• The provider did not maintain effective oversight of staff training and not all staff had received appropriate training in line with policy.
• Policies and procedures were not fully embedded. For example, recruitment checks were not consistent and inline with policy.
• Patients said they were treated with compassion, dignity and respect; and they were involved in their care and decisions about their treatment.
• Information about services was available and easy to understand. 

The areas where the provider must make improvements as they are in breach of regulations are: 

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

The areas where the provider should make improvements are:

• Monitor patient outcomes to identify opportunities for improvement.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care