Archived: Harley Street Homecare Limited

We carried out an announced inspection on 18 October 2017 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.

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 not providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was not 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.

Background

Harley Street Homecare Ltd is an independent provider of medical services and treats adults in the London Borough of Westminster. The clinic is attached to a private pharmacy. The clinic is led by an independent prescribing pharmacist who is the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Medical consultations for minor ailments and for patients with long term conditions are carried out by the independent prescribing pharmacist. Locum doctors and GPs were used to review complex patients when required. The provider also offered travel vaccinations and a dispensing pharmacy service for patients in the same premises.

The service employs one reception and administrative staff. The service use one regular locum doctor (not on the GP register) and one regular locum GP who do not have a contract with the service.

The clinic is located in the lower ground floor. The property is leased by the provider and consists of a small reception area, a consulting room, a travel clinic room and a pharmacy. The clinic is open between 10am and 7pm Monday to Friday.

The provider informed us that they are not busy and have only seen five patients in the last year. The clinic has a problem with damp descending from the roof which had damaged their walls. The registered manager informed us that due to this issue they are actively looking to move to new premises.

Harley Street Homecare Ltd is registered with the Care Quality Commission to provide the regulated activity treatment of disease, disorder or injury.

Our key findings were:

• There were limited arrangements in place to keep patients safe. We identified issues in relation to responding to medical emergencies, safeguarding, infection control, staff recruitment and the safe use of medicines.
• There was some evidence that staff were aware of current evidence based guidance. Not all staff had been trained to provide them with skills and knowledge to deliver effective care and treatment.
• There was limited evidence of quality improvement and they had not done any clinical audits.
• Information on how to complain was available. The clinic had not received any complaints in the last 12 months.
• There were limited governance arrangements in place. The policies and procedures in place were not adequate.

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

• Ensure care and treatment is provided in a safe way for service users including a system in place for managing significant events, safeguarding, infection control, staff recruitment, responding to medical emergencies, monitoring of the health and safety of patients and staff, the safe use of medicines and there is a business continuity plan in place.
• Ensure medicines are managed safely.
• Ensure patient needs are assessed and care delivered in line with relevant and current evidence based guidance and standards and there is a quality improvement process in place.
• Ensure there is a system in place to allow written communication between the clinic and patients’ NHS GPs.
• Ensure there is formal supervision and support for clinical staff.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure policies and procedures are in place and they are up to date.

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 practice procedures to ensure that there is a chaperone policy in place and notices displayed to advise patients that chaperones are available if required.
• Review practice procedures to ensure there is a system in place to monitor the use of prescriptions used for controlled drugs.