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Inspection Summary


Overall summary & rating

Updated 13 December 2017

We carried out an announced comprehensive inspection of Chelsea Bridge Clinic on 2 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 providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was 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 providing well-led care 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.

Aspen Medical Services Ltd provides private medical services from purpose built premises at Chelsea Bridge Clinic, Ground Floor Riverfront, Howard Building, London, SW8 4NN. The clinic provides whole health and well-being solutions offering services including physiotherapy, hyperbaric oxygen therapy, dermatology, cosmetic services, weight loss services including nutritional therapy and personal training programmes, acupuncture, coaching, laser aesthetics and blood collection.

The premises consist of a ground floor, level access patient reception and waiting area, second patient waiting room, fitness studio, consultation rooms, treatment room and hyperbaric oxygen therapy room. There are also storage and maintenance areas and staff offices on the ground floor. A mezzanine level provides space for a third patient waiting area, shower room and treatment rooms for the wellbeing services offered.

Clinic services are available to any fee paying patient and is primarily focussed on services for adults.

The service has one director and one clinic manager. The clinic staff include physiotherapists, personal trainers, men’s health specialist, nutritionist, consultant dermatologist, hyperbaric oxygen therapist, a registered nurse, nurse assistant and reception hosting and administrative assistants. Those staff who are required to register with a professional body were registered with a licence to practice. Relevant staff were also registered for providing specialist services. The clinic outsourced its human resources, accounting, information technology, telephony and legal services, with the clinic manager responsible for monitoring contracts.

The service operates Monday to Saturday and on Sunday by request. Clinic hours run from 11am to 8pm on a Monday, 8.30am to 9pm Tuesday to Friday and 8.30am to 5.30pm on a Saturday. The clinic does not offer out of hours services but does offer patients enquiring about out of hours care contact details for a separate provider for this service.

Since 2008 the clinic has provided services for 16,700 patients across all of its services. The dermatology service is operated by a consultant dermatologist providing one clinic per month with an average of three to seven patients. The majority of appointments are consultation with very few minor surgery procedures being carried out at the clinic. Hyperbaric oxygen therapy appointments are available three to four days a week with an average of six to eight patients per clinic. Hyperbaric oxygen therapy is provided at a level considered as complimentary treatment to alleviate a range of symptoms and support recovery and wellbeing and is not a cure or treatment for specific medical conditions. Complex medical cases are referred to specialist hyperbaric oxygen therapy services.

The clinic manager 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. The clinic is registered with the Care Quality Commission (CQC) to provide the regulated activities diagnostic and screening procedures, surgical procedures and treatment of disease, disorder or injury,

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. We received 31 comment cards which were all extremely positive about the standard of care received, across all of the services offered. Comments included that staff, were kind, caring, welcoming, helpful and treated patients with respect. Comments about the service included that the clinic was clean and hygienic, that patients felt listened to, they were given a thorough explanation of treatment options and that the treatment they received was effective. We also spoke with two patients during the inspection who said they were very satisfied with the care they received and told us that appointments ran on time but that they were not rushed, that they were involved in their care and treatment and that the clinic provided an excellent level of service to their whole family.

Our key findings were:

  • The clinic had a clear vision, embedded in the service culture, to deliver high quality care for patients.
  • There was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice.
  • The service had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
  • The service had adequate arrangements to respond to emergencies and major incidents.
  • Staff were aware of and used current evidence based guidance relevant to their area of expertise to provide effective care.
  • Staff had the skills and knowledge to deliver effective care and treatment.
  • Staff sought and recorded patients’ consent to care and treatment in line with legislation and guidance.
  • Information we reviewed showed that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Patient dignity, privacy and respect was highly valued.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management.
  • The clinic proactively sought feedback from staff and patients and we saw examples where feedback had been acted on.

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

  • Review how safety alerts are received, reviewed and actioned where appropriate.
  • Review the requirement for business continuity arrangements to be available in a single business continuity plan.
  • Review how access to services and information may be improved for patients with disabilities.
Inspection areas

Safe

Updated 13 December 2017

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

We found areas where improvements should be made relating to the safe provision of treatment. This was because the providers’ business continuity arrangements were not amalgamated into one business continuity plan.

  • From the sample of documented examples we reviewed, we found there was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice.
  • There were systems in place to ensure that when things went wrong patients would be informed as soon as practicable, receive reasonable support, truthful information, and a written apology, including any actions to improve processes to prevent the same thing happening again.
  • The service had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
  • Staff demonstrated that they understood their responsibilities and all had received training on safeguarding children and vulnerable adults relevant to their role.
  • The service had adequate arrangements to respond to emergencies and major incidents.

Effective

Updated 13 December 2017

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

  • Staff were aware of and used current evidence based guidance relevant to their area of expertise to provide effective care.
  • Staff had the skills and knowledge to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • The service had effective arrangements in place for working with other health professionals to ensure quality of care for the patient.
  • Staff sought and recorded patients’ consent to care and treatment in line with legislation and guidance.

Caring

Updated 13 December 2017

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

  • Information we reviewed showed that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • Patient dignity, privacy and respect was highly valued.

Responsive

Updated 13 December 2017

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

We found areas where improvements should be made relating to the service responding to the needs of patients. This was because the provider had not reviewed how patients with disabilities, including patients with hearing and vision impairments, may be better able to access information and use services.

  • The service understood its client base and had used this understanding to meet the needs of its clients through improving existing services and introducing new services.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and evidence from examples reviewed showed the service responded quickly to issues raised.
  • Learning from complaints and feedback was shared and acted upon.
  • The clinic provided high levels of discretion, privacy and respect for all service users.
  • Treatment costs were clearly laid out and explained in detail and there were options for purchasing treatment packages providing added value for patients.

Well-led

Updated 13 December 2017

We found that this service was providing well-led care in accordance with the relevant regulations.

We found areas where improvements should be made relating to the provision of well-led services. This was because the service did not have a formal system for receiving and acting on patient safety alerts.

  • The clinic had a clear vision, embedded in the service culture, to deliver high quality care for patients.
  • There was a clear leadership structure and staff felt supported by management.
  • The service had policies and procedures to govern activity and held regular governance meetings.
  • An overarching governance framework supported the delivery of and high quality care. This included arrangements to monitor and improve quality and identify risk; however arrangements for receiving and acting on medicines, patient safety and medical device alerts were informal.
  • Staff had received inductions, annual performance reviews and attended staff meetings and training opportunities.
  • The provider was aware of and had systems in place to meet the requirements of the duty of candour.
  • There was a culture of openness and honesty. The practice had systems for being aware of notifiable safety incidents and sharing the information with staff and ensuring appropriate action was taken.
  • The clinic proactively sought feedback from staff and patients and we saw examples where feedback had been acted on.
  • There was a focus on continuous learning and improvement at all levels. Staff training was a priority and staff had protected learning time.