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Archived: Cambridge Clear Ear

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Updated 22 March 2018

We carried out an announced comprehensive inspection on 25 February 2018 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.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the services it provides.

Mjollnir Medical Limited is an independent provider of aural care services and offers a specialist service of microsuction treatment to people on a pre-bookable appointment basis. Microsuction is treatment to remove wax from patients’ ears.

Mjollnir Medical Limited is registered with the Care Quality Commission to provide services at Cambridge Clear Ear, 47 Norfolk Street, Cambridge CB1 2LD. The clinic is based close to the city centre of Cambridge. The property is a house that has been converted to provide rooms to a number of different practitioners. The accommodation used by Cambridge Clear Ear Clinic consists of a patient waiting room, reception area and two consulting rooms which are located on the ground floor of the property. There is on site car parking. We only inspected the areas used by the provider during this inspection.

The service offers services to patients aged over 18 years old who reside primarily in East Anglia and surrounding areas, however the clinic also see patients who live in other areas of England who require their services.

The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

As part of our inspection we reviewed 20 of the 70 provider’s questionnaires, collected between April 2016 and February 2018, where patients and members of the public shared their views and experiences of the service; all of the cards were positive about the service experienced. Patients said they were offered an excellent service and staff were helpful, caring and treated them with dignity and respect. Patients reported they received information to help them make informed decisions about their care and treatment. We received one Care Quality Commission comment card, this was positive about the care and service the patient had received.

The provider who is a GP registered with the General Medical Council delivers the service to patients supported by one employed nurse.

The service is open from 8am until 5pm on Sundays.

After treatment, the provider gives each patient treated a direct contact number to call in case of concerns and patients are made aware they can call 111 to access out of hours services. This is detailed on the service website and its patient guide.

Our key findings were:

  • Although none had been reported, we were assured there was an effective system in place for reporting and recording significant events.
  • Information about services and how to complain was available and easy to understand. Although none had been received, we were assured that the systems and processes in place would ensure that complaints were fully investigated and patients responded to with an apology and full explanation.
  • Staff had received a Disclosure and Barring Service (DBS) check.
  • Risks to patients were assessed and well managed. We found that the provider had taken mitigating actions where shortfalls in the accommodation could affect patients. For example, the provider brought supplies such as soap and hand towels each Sunday when they were providing services.
  • The service held a comprehensive central register of policies and procedures which were in place to govern activity; staff were able to access these policies.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Staff had the skills, knowledge, and experience to deliver effective care and treatment.Patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
  • 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 service proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.
Inspection areas

Safe

Updated 22 March 2018

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

  • Although none had been reported, we saw there were systems and processes to manage unintended or unexpected safety incidents. Staff we spoke with detailed how patients would receive reasonable support, detailed information and a verbal and written apology. They would be told about any actions to improve processes to prevent the same thing happening again.
  • The service had clearly defined and embedded systems, processes, and services in place to keep patients safe and safeguarded from abuse.
  • There were recruitment processes in place. Staff had received a Disclosure and Barring Service (DBS) check. The GP and nurse saw all patients jointly and therefore patients were not offered additional chaperones.
  • There were various risk assessments in place. However the landlord who was regulated by other bodies such as the local council carried some of the assessments out. The provider did not have direct access to the report for providing safe water and the control of Legionella (Legionella is a term for a particular bacterium which can contaminate water systems in buildings). The provider gave us this information after the inspection.
  • The service held evidence of Hepatitis B status and other immunisation records for clinical staff members. The service did not use any sharps equipment.

Effective

Updated 22 March 2018

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

  • Staff had the skills, knowledge, and experience to deliver effective care and treatment.
  • All members of staff were suitably trained to carry out their roles. We saw evidence that the GP provider had undertaken 20 supervised microsuction appointments to ensure they were competent.
  • There was evidence of appraisals, induction processes and personal development plans for all staff. The provider fully supported the nurse through revalidation.
  • The service ensured sharing of information with NHS GP services and general NHS hospital services when necessary and with the consent of the patient. There was a consent policy in place and we saw that written consent was always obtained.
  • The provider had carried out audits to monitor and improve their effectiveness in areas such as consent and effectiveness of treatment. The provider had only treated a small number of patients and the audits did not identify any concerns.

Caring

Updated 22 March 2018

We found that this service was providing caring services in accordance with

the relevant regulations.

  • Patients said they were treated with compassion, dignity, and respect and they were involved in decisions about their care and treatment.

  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality. The provider was able to evidence patient feedback cards. We viewed 20 of the 70 feedback questionnaires and they were wholly positive.

  • Staff had received training in confidentiality and the Mental Capacity Act.

Responsive

Updated 22 March 2018

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

  • The provider offered pre bookable consultations. The patients received an initial assessment by telephone to ensure they were suitable to use the service. For example, the service had a clear exclusion criteria which included checking the date of birth of the patients to ensure they were aged over 18, checking their medical history as certain pre-existing medical conditions were excluded and patients were unsuitable to receive microsuction in a community setting.
  • Information for patients about the services available to them and the related fees was easy to understand and accessible.A schedule of fees was provided to all patients.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • Information about how to complain was available, easy to understand. At the time of our inspection, the service had not received any complaints.
  • The service did not have access to interpretation services such as Language Line for patients whose first language was not English. The provider and staff made this clear to patients or their relatives and ensured that patients understood the process, charges, and consent before they agreed to treatment. At the time of our inspection, the staff told us they had not received any requests for treatment from patients who were not able to speak or fully understand English.
  • There was an information guide and written information was available to patients. This information was available in large print and Braille for those patients whose sight or hearing was impaired.
  • Fees were explained to patients as part of the booking process to ensure openness and honesty.

Well-led

Updated 22 March 2018

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

  • There was a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to this. The business plan was reviewed on an annual basis.
  • There was a clear leadership structure and staff felt supported by management. The provider had a number of policies and procedures to govern activity and discussed these with the nurse.
  • An overarching governance framework supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider encouraged a culture of openness and honesty.
  • Staff told us they had received comprehensive induction and training programmes.
  • The provider proactively sought feedback from staff and patients and made changes to the service delivery as a result.