15/05/2019
During a routine inspection
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