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Archived: Medical Slimming Clinic - Rotherham

Reports


Inspection carried out on 13 July 2017

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection of this service on 19 January 2017. Breaches of legal requirements were found in relation to breaches of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to confirm the provider now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Medical Slimming Clinic –Rotherham on our website at www.cqc.org.uk. We carried out a focused inspection on 13 July 2017 to ask the service the following key questions: Are services safe, effective 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 because medicines were not managed safely, and appropriate checks or risk assessments had not been carried out as part of the recruitment processes for clinical staff.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations because medicines were not prescribed safely in line with the Medical Slimming Clinic policy and the process in place for sharing information with GPs when patient’s have complex medical conditions was not robust.

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Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations because the provider did not have systems and processes in place to monitor and improve the quality of the service being provided.

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.

At the last inspection on the 19 January 2017 we found a breach of legal requirements Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment because the provider failed to monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk which arise from the carrying on of the regulated activity.

Specifically equipment had not been tested or calibrated, systems were not in place to safely manage medicines and there were inadequate infection control measures in place at the service. We checked this as part of this focussed inspection and found that some areas had not been resolved.

Also at the last inspection on the 19 January 2017 we found a breach of legal requirements Regulation 17 HSCA (RA) Regulations 2014 Good governance because the provider failed to assess, monitor and improve the quality and safety of the services provided or to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk which arise from the carrying on of the regulated activity.

Specifically the provider did not thoroughly, monitor and mitigate all potential health and safety risks. Employment checks had not been performed. Service users were not protected from abuse.

We checked this as part of this focussed inspection and found that some areas had not been resolved.

Medical Slimming Clinic Limited has two sites; one in Doncaster and one in Rotherham. We inspected the Rotherham location which is located near Rotherham city centre. The service comprises of a reception, office areas and one clinic room. A toilet facility is available on the clinic premises. There are clinicians, a manager, receptionist and cleaner who work at the service. The service is open Tuesday 4pm to 6pm Thursday 11am to 1pm and Saturday 10am to 12 noon. Slimming and obesity management services are provided for adults from 18 to 65 years of age either by appointment or on a ‘walk –in’ basis.

Our key findings were:

  • The Provider had improved the recruitment documentation in the service.
  • Consent was obtained before treatment commenced.

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

  • Ensure there are safe systems in place for the management of medicines.
  • Ensure there are effective systems and processes in place to assess, monitor and improve the quality of services being provided.
  • Ensure that doctors working at the service have the appropriate medical indemnity insurance.
  • Review the process for starting medicines in people with a body mass index less than 30 kg/m2 to ensure that national guidance and the clinic policy is followed.

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:

  • Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
  • Review the need for a risk assessment for chaperoning at the service and staff training requirements as necessary.

Inspection carried out on 19 January 2017

During a routine inspection

We carried out an announced comprehensive inspection on 19 January 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 care in accordance with the relevant regulations because safety systems and processes were not reliable, proper recruitment checks had not been carried out, infection prevention and control arrangements were inadequate, medicines were not managed safely, and equipment was not maintained appropriately.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations because decisions about treatment were not always clearly recorded in patient’s records and medicines were not prescribed in line with manufacturer’s recommendations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations as staff were friendly and helpful however, the environment was not conducive to support people's privacy.

Are services responsive?

We found that this service was not providing responsive care in accordance with the relevant regulations as the service was inaccessible to patients with mobility difficulties, there was no hearing loop and information was not available in other languages. The clinic did not have access to an interpreter service.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations because the provider did not have adequate systems and processes in place to monitor and improve the quality of the service being provided.

Our key findings were:

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

  • Ensure adequate infection control measures are in place at the service.
  • Ensure proper recruitment checks are carried out prior to employment.
  • Ensure robust systems and processes are in place to prevent abuse of service users.
  • Ensure all electrical appliances on the premises have been PAT tested, and medical equipment is regularly calibrated.
  • Ensure there are safe systems in place for the management of medicines.
  • Ensure there are systems and processes in place to monitor and improve the quality of services being provided.
  • Introduce an up to date record of appraisals and system to confirm revalidation of medical staff.
  • Ensure risk assessments are completed for emergency medicines and equipment.

  • Ensure treatment protocols clearly set out when it is appropriate to prescribe medicines, and that unlicensed medicines are only supplied against valid special clinical needs of an individual patient where there is no suitable licensed medicine available

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 methods to encourage feedback from patients and show how patient feedback is driving improvements within the service
  • Review interpretation services offered to clients who speak another language
  • Review adjustments for disabled patients to ensure they are not disadvantaged compared to non-disabled patients.
  • Review facilities to maintain dignity and privacy of service users.
  • Review the process for sharing details of consultations for patients who do not opt out of information being shared with their GP.

Inspection carried out on 21 May 2013

During a routine inspection

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We looked at 10 people’s treatment records and found there was evidence that people had completed a consent to treatment form. The form also contained a box to tick if they did not want their doctor to be informed about their attendance at the clinic.

We saw evidence of letters which had been given to people to take to their doctor (if they wished) which stated the medication prescribed. The letters were signed by the person and prescribing doctor at the clinic.

Leaflets were available for people in reception so that they were informed about how the medication prescribed should be taken. The leaflet also contained advice about diets and taking regular exercise.

We spoke with the doctor about obtaining consent before treatment commenced and she told us the initial consultation was important to ensure people understood their treatment options.

Inspection carried out on 15 May 2012

During an inspection to make sure that the improvements required had been made

We have not spoken with people who used the service during this inspection. However the inspection report dated 16 February 2012 contains the views of people who used the service.

At this inspection we gathered evidence of people’s experience of the service by reviewing recent patient feedback forms. Some of the feedback referred to interviews undertaken by inspectors at previous inspections. They said they were unhappy about discussing the reasons for them attending the clinic.

Inspection carried out on 1 March 2012

During an inspection to make sure that the improvements required had been made

We spoke with three people who used the service who told us they were happy with the service provided by the clinic. However, one person said it would have helped if they had been given a healthy eating plan. Two people said that they had received a ‘pink card’ which gave some information regarding the types of food they should eat. They also told us that it was explained to them that they should only eat three small meals a day and drink lots of water. All three people we spoke with told us that no advice had been given regarding exercise or lifestyle options.

People said that they were told about the medicines prescribed at the clinic when they first started treatment and that they discussed the side effects with the doctor on their follow up appointments. However, not all the people we spoke with had been given a copy of the clinics medicines information leaflet.

Two people told us that all the staff were, “Quite nice”. Another person said that they were, “Guaranteed to lose weight”.

Inspection carried out on 1 November 2011

During a routine inspection

We spoke with one person using the service who told us they had been to the clinic on and off for the past two years. They told us they were happy with the service they had received during this period. However, they were not aware of the side effects from the drugs they were prescribed by the clinic and were not given a healthy living and diet plan.