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Inspection carried out on 16 July 2019

During a routine inspection

This service is rated as Good overall. (Previous inspection November 2017, the clinic was not rated and was meeting the requirements).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Chelsea Bridge Clinic as part of our inspection programme. We inspected all five key questions.

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 services in dermatology, orthopaedics and general health (including general practice appointments).

This service 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 exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Chelsea Bridge Clinic provides a range of non-medical and complimentary therapies (e.g. physiotherapy, acupuncture, coaching, personal training and hyperbaric oxygen therapy) and cosmetic interventions (including laser aesthetics) which are not within CQC scope of registration. Therefore, we did not inspect or report on these 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.

Fifteen people provided feedback about the service.

Our key findings were:

  • There were systems to assess, monitor and manage risks to patient safety.
  • Systems and processes kept patients safe from abuse. Staff whose records we checked had completed appropriate safeguarding training for their role, although it was not practice policy that clinical staff should have level three training in child safeguarding. There was a system to assure that an adult accompanying a child had parental authority, but this was informal rather than formally documented.
  • There was equipment and medicines to deal with medical emergencies. These were adequate for the services fully implemented at the time of the inspection, but did not cover all of the most common risks for the services that the clinic provided.
  • We saw evidence that clinicians assessed needs and delivered care and treatment in line with current legislation, standards and guidance (relevant to their service).
  • There was quality improvement activity, although this was not consistent across the whole service. The clinic was developing measures of effectiveness for its newer medical services.
  • Staff had the skills, knowledge and experience to carry out their roles, and worked together, and worked well with other organisations, to deliver effective care and treatment.
  • Staff supported patients to manage their own health, and obtained consent in line with legislation and guidance.
  • Staff treated patients with kindness, respect and compassion and helped patients to be involved in decisions about care and treatment.
  • The service organised and delivered services to meet patients’ needs. It took account of patient needs and preferences.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
  • The service had a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients.
  • There were clear responsibilities, roles and systems of accountability to support good governance and management.

We saw the following outstanding practice:

  • The service had reviewed safety systems in other healthcare systems and other industries and had recently introduced a ‘good catch’ process. Good catches were defined as issues that could have caused injury, incident or a deterioration in the quality of care had they not been rectified.
  • Good catches were noted on a form that included the issue identified, the risk level, the root and contributory cause and the action taken.
  • The service was sharing the good catches with staff and using them to identify areas for staff/policy development. Short video reminders for staff were being created to reinforce key messages.

The areas where the provider should make improvements are:

  • Review the training policy to check this is aligned with national guidance, e.g. on safeguarding. Consider formalising the system for verifying patient identity and adults accompanying children.
  • Review the emergency medicines and equipment to check they are adequate for the services being developed.
  • Review measures of effectiveness to develop comprehensive measures across all of the services offered. Consider how governance will remain effective when new specialities are added.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 2 November 2017

During a routine inspection

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.