Tooting and Clapham Clinics

Updated 29 August 2018

Tooting Med Centre Ltd is an independent provider of medical, dental and aesthetic services and treats both adults and children. The address of the registered provider is 5 London Road, London, SW17 9JR. Tooting Med Centre Ltd is registered with the Care Quality Commission to provide the regulated activity diagnostic and screening procedures, surgical procedures and treatment of disease, disorder or injury. They are also registered to provide termination of pregnancies at the provider’s other location. Regulated activities are provided at two clinic locations in South London; we inspected the location Doctors and Dentists of South London based in Clapham.

The organisation is run by the nominated individual for the provider. There is a registered manager, who is the general manager of the service in Clapham. 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 a 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 housed over two floors in newly refurbished premises. The premises consist of a patient waiting and reception area, three consultation rooms, two aesthetic treatment rooms, a dental surgery and a patient toilet on the ground floor. One consultation room is accessible at street level for patients with restricted mobility. The basement level is accessed by stairs and consists of a minor surgery room, a dental surgery, a dental x-ray room, decontamination room, and three consultation rooms plus a staff area and patient toilet.

The clinic is open between 9am and 8pm Monday to Friday and 10am to 6pm Saturday and Sunday. Services are available to people on a pre-bookable appointment basis and their clientele is primarily patients of Polish origin.

Regulated services offered at the clinic include proctology, dermatology, paediatric, orthopaedic and gynaecological consultations, minor surgery including joint injections, varicose veins treatment and and routine and emergency dental services. The clinic were also able to provide adult male circumcision services, however no circumcisions had yet been carried out so this was not inspected or reported on. At Tooting Med Centre Ltd the aesthetic treatments that are provided by therapists are exempt from CQC regulation and as such were not inspected or reported on.

The service has been operating for just over a year. Aesthetic and dental services were provided initially and the provider slowly introduced medical services; minor surgery commenced two months previously. For June 2018, there were 1126 appointments in total. Of these, 49% were for regulated activities; 368 were for dental services and 185 were for medical services including minor surgery.

Practice staff providing dental services consists of six dentists, one dental nurse and three trainee dental nurses and a practice manager. Medical services are provided by 10 part time doctors, who are specialists across a range of medical fields. Five doctors reside in Poland and regularly travel to England to provide services for the provider. The medical team also consists of a nurse. Other health care staff include beauty therapists and a physiotherapist. Administrative support for the medical and dental teams is provided by four reception staff members and two service managers.

How we inspected the service:

Our inspection team on 17 July 2018 was led by a CQC Lead Inspector and included a GP Specialist Advisor. The inspection team on 18 July 2018 was led by a CQC Lead Inspector and included a dental Specialist Advisor.

Before visiting, we reviewed a range of information we hold about the service.

During our visit we:

• Spoke with three doctors.
• Spoke with the nurse.
• Spoke with one dentist.
• Spoke with the qualified dental nurse.
• Spoke with one receptionist.
• Spoke with the registered manager of the service and a general manger.
• Spoke with the director of the service
• Looked at the systems in place for the running of the service.
• Viewed a sample of key policies and procedures.
• Explored how clinical decisions were made.
• Made observations of the environment.
• Reviewed feedback from four patients including CQC comment cards.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 29 August 2018

We carried out an announced comprehensive inspection on 17 and 18 July 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.

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. We also planned the inspection to check on concerns raised which we had received.

Tooting Med Centre Ltd provides private medical, dental and aesthetic services at Doctors and Dentists of South London in Clapham, in the London Borough of Wandsworth. Services are provided to both adults and children.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical or dental practitioner, including the prescribing of medicines. At Tooting Med Centre Ltd the aesthetic treatments that are provided by therapists are exempt from CQC regulation.

We received feedback from three people about the service, including comment cards, all of which were very positive about the service and indicated that patients were treated with kindness and respect. Staff were described as helpful, caring, thorough and professional.

Our key findings were:

• The practice was clean and well maintained.
• There were safe systems for the management of medicines and infection control.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had a number of systems to help them manage risk.
• There was a system for recording and acting on adverse events, incidents and safety alerts.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Doctors and dentists were carrying out assessment and treatment in line with current evidence based guidance and standards.
• There was evidence of some quality improvement measures.
• The practice had effective systems for induction, supervision, training and appraisals for all staff.
• Consent policies were in place but consent was not consistently recorded in some cases.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice dealt with complaints positively and efficiently.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.
• The practice reviewed feedback from patients and staff about the services they provided.

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

• Review the current health and safety risk assessments to ensure that all risks have been considered.
• Review the systems for recording vaccinations for clinical staff.
• Review the processes for sharing information with patients’ GPs.
• Review the quality improvement systems to ensure that medical assessments and treatments are monitored and are in line with relevant and current evidence based guidance and standards.
• Review the systems for ensuring staff understand the requirements of legislation and guidance when considering consent and decision making in relation to children under 16 and review the systems for monitoring the recording of consent.