Archived: ABC Clinic Limited

Updated 16 January 2018

The inspection was led by a CQC inspector and a GP specialist advisor.

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 16 January 2018

We carried out an announced comprehensive inspection on 3 November 2017 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 services in accordance with the relevant regulations

Are services effective?

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

Background

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.

ABC Clinic Limited provides private independent doctor services to people who reside in the UK and overseas. Services include diagnostic and screening or referral to specialist screening services. The provider consists of one clinician, a practice manager and personal assistant. The service has approximately 500 active clients on their list.

Dr Josef Kees 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.

Services are provided from the following locations:

Lewes RoadEast GrinsteadRH19 3TBWest SussexUnited Kingdom

And

The provider also has use of rooms to provide consultations at :

10 Harley StreetLondonW1G 9PF

The practice is open Monday to Friday 8.30am until 6.00pm. Consultations are usually provided on Thursdays at Harley Street and no clinician is available at the East Grinstead service on that day.

We did not visit the Harley street location as part of this inspection.

Nineteen people provided feedback about the service. This included feedback through Care Quality Commission comment cards and face to face interviews.

Our key findings were:

• Patients were at risk of harm because systems and processes were not in place in a way to keep them safe. For example, risk assessments were not in place and action had not been taken to mitigate the risks. For example there was no health and safety risk assessment.

• Safeguarding policies were not in place and safeguarding training was not undertaken.

• There was no infection control system, the policy was more than seven years out of date for review and an infection control audit had not been undertaken. There were no cleaning schedules and staff had not received infection control training.

• The practice did not have emergency medicines in place or a rationale for why they were not available on site.

• Recruitment processes were in place, however staff recruited in the two months prior to the inspection did not have satisfactory information about conduct in previous work prior to commencing work. The practice had no system to ensure staff roles were risk assessed and if required a DBS check undertaken.

• There was no evidence of quality improvement initiatives including clinical audit.
• The service learning needs of staff were not identified through a system of appraisals, meetings and reviews of practice development needs. Systems were yet to be established to allow staff access to appropriate training to meet their learning needs and to cover the scope of their work.
• Patient records did not always demonstrate that information was shared when appropriate.
• The practice had only one policy and procedure to govern activity; this was not sufficient to address all aspects of the service and had not been reviewed since 2009.

• Patients said they felt the practice offered an excellent service and staff were helpful, caring and treated them with dignity and respect.

• Patients told us that it was very straightforward to make an appointment and they could arrange these around their other commitments.

We identified regulations that were not being met and the provider must:

• Ensure that there is an accessible health and safety policy and that risk assessments are carried out and acted upon. Including for fire safety, infection control and management of legionella.

• Ensure that all staff attend fire safety training, that regular fire drills are carried out and where necessary, improvements in practice are demonstrated as a result.

• Review and update all practice policies, ensuring that policies are accessible to all staff.

• Ensure that infection control protocols are up to date, that there is an identified and trained infection control lead within the practice, that annual infection control audits are undertaken and that all staff attend infection control training.

• Ensure recruitment arrangements include all necessary employment checks for all staff and that these are undertaken before employment commences.

• Ensure that clinical audits are undertaken, demonstrating improvements and that there is evidence of shared learning as a result.

• Ensure a risk assessment is carried out for all roles within the practice to identify which roles should be subject to a DBS (Disclosure and Barring Service) check.

• Introduce a system that ensures all staff have training appropriate to their role and an annual appraisal.
• Ensure safeguarding policies are in place for children and adults and staff receive appropriate training.
• Ensure all patient records are complete and contain the information required to demonstrate that advice had been given to patients and where appropriate documented proof that referrals have been made. Records must also include evidence that the patient’s GP has been informed of any treatment or a clear rationale why this has not been undertaken.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review the service’s complaint policy and procedures in relation to the steps a complainant can take if still dissatisfied with the response from the provider.
• Review the access arrangements for patients with limited mobility and reflect the outcome in an access statement and policy.