Archived: Newland Clinics ,Scope Healthcare Consulting Limited

Updated 11 June 2018

Newland Clinics, Scope Healthcare Consulting Limited, 196 Newland Avenue, Hull, East Riding of Yorkshire, HU5 2NE is an independent clinic operated by Scope Healthcare Consulting Limited to deliver private GP services to patients. All regulated activity is currently delivered from this one, registered location.

The clinic is open from 10am until 4pm Monday to Friday and there is one GP and a practice assistant. Other clinicians are employed at the service on an ad hoc basis to carry out some of the regulated activities on behalf of the provider.

The Care Quality Commission undertook an announced comprehensive inspection of Newland Clinics, Scope Healthcare Consulting Limited on 4 April 2018. The inspection was carried out by a CQC lead inspector and a GP Specialist Advisor.

The Commission request information from services in advance of announced inspections. The provider failed to act on this request and no information was submitted.

We informed the Clinical Commissioning Group (CCG) that we were inspecting the service. We did not receive any information of concern from them.

As part of our inspection methodology we conducted interviews with staff, undertook observations of the premises and reviewed key documents.

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 11 June 2018

We carried out an announced comprehensive inspection on 4 April 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The service provides private GP services. The provider is registered with Care Quality Commission (CQC) to provide the following regulated activities; diagnostic and screening procedures, family planning, surgical procedures and treatment of disease, disorder or injury. The service also offers other treatment that is exempt by law for CQC regulations, for example Botox injections.

The provider 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 Act 2008 and associated Regulations about how the service is run.

We did not speak directly to any patients on the day of the inspection as there were no planned consultations on the day. However, eight people provided positive feedback about the service to the Commission. Patients commented that staff at the clinic were welcoming and helpful.

Our key findings were:

• Processes for reporting incidents and significant events were ineffective and systems for dealing with safety alerts were not reliable.
• Medicines, oxygen and equipment for dealing with medical emergencies were not in place and vaccines were not correctly stored.
• Antibiotic prescribing and monitoring was not based on national guidelines.
• Policies and procedures were in place however, these were generic and not specific to the practice and required review.
• The internal premises looked clean and tidy, however, there were no cleaning schedules in place. An Infection and Prevention Control (IPC) audit had not been undertaken. Externally the premises were poorly maintained and there was evidence of rodent infestation.
• The provider could demonstrate they had range of services and fees which were available for patients to review.
• The practice had a duty of candour policy in place however the provider could not demonstrate their understanding or responsibility of this. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).
• There was a lack of overarching governance arrangements in place that meant patients were not kept safe from avoidable harm.
• Documented consultations were poor; for example, baseline observations, past medical history, and appropriate consent to treatment was not recorded consistently in the patients records.
• Staff who were employed at the service had not received the appropriate support, training and professional development necessary to enable them to carry out their duties.
• There were no environmental risk assessments available at the inspection and we saw that no fire system checks had been carried out since 2016. Additionally there was no evidence that medical equipment had been serviced or tested.
• The provider had not ensured that appropriate medical indemnity cover was in place for the clinicians working at the service to carry out private practice.

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

• Care and treatment must be provided in a safe way for service users.
• Systems and process must be established and operated effectively to ensure compliance with the requirements of the fundamental standards of care.

As a result of these failures we have concluded patients are at serious risk of receiving unsafe care or treatment. Due to the serious concerns we found regarding the safety of patients we immediately wrote to the provider following the inspection under Section 31 of the Health and Social Care Act 2008, asking them to provide us with assurance that they would take action immediately to mitigate identified risks to patient safety in terms of patient care, treatment and welfare. The provider wrote to us and told us that they would suspend carrying out any regulated activities until such times that they were compliant with the regulations . We also informed the provider that we would be issuing a notice to suspend the provider’s registration until such times that they could demonstrate that they were meeting with regulation and that patients who used the service were kept safe and protected from improper care and treatment.

We are taking action in line with our enforcement procedures. The service will be kept under review and if needed could be escalated to urgent enforcement action.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice