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Inspection carried out on 18 March 2019

During a routine inspection

We carried out an announced comprehensive inspection on 18 April 2019 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.

CQC inspected the service on 7 June 2018 and asked the provider to make improvements for providing care and treatment in a safe way and protecting patients’ dignity and respect. We checked these areas as part of this comprehensive inspection and found this had been resolved.

Citydoc Canary Wharf is an independent health service based in Canary Wharf, London.

Our key findings were:

  • The service had systems to assess, monitor and manage risks to patient safety, and reliable systems for appropriate and safe handling of medicines. The service learned from, and made changes as a result of, incidents and complaints.
  • The service assessed need and delivered care in line with current legislation, standards and evidence based guidance. There was no programme of regular audits in place, however the service did carry out mandatory audits through which it reviewed the effectiveness and appropriateness of the care provided.
  • The service gave patients a full travel health assessment and tailored immunisation plan, taking into account medical history, the destination and method of travel and any associated risks.
  • The service treated patients with kindness, respect and compassion.
  • The service organised and delivered services to meet patients’ needs.
  • There was a clear leadership structure in place, and staff told us that they felt able to raise concerns and were confident that these would be addressed.
  • The service had a governance framework in place, which supported the delivery of quality care, and processes for managing risks, issues and performance.

Whilst we did not find any breaches of the regulations, there were areas where the provider could make improvements and should:

  • Review the arrangements for quality improvement activity, including a regular programme of completed audits.
  • Review the facilities in place to monitor the temperature of the fridge and consider the usefulness of a back-up thermometer .

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 07/06/2018

During a routine inspection

We carried out an announced comprehensive inspection on 7 June 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 not 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, in one area, this service was not 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.

Citydoc Canary Wharf is an independent health service based in Canary Wharf, London.

Our key findings were:

  • Clinicians had completed appropriate safeguarding and basic life support training, however the service did not have any oversight of whether reception staff had completed this training.
  • The chaperone system was not effective to maintain patient safety.
  • Appropriate emergency medicines and equipment were accessible for staff and we saw evidence of regular checks.
  • The systems for managing medicines, including vaccines, medical gases, and emergency medicines and equipment minimised risks.
  • The service had a system in place to verify that adults attending with children for appointments had parental responsibility.
  • The service delivered care in line with relevant and current evidence based guidance and standards.
  • Updates and best practice guidelines were shared amongst clinicians by email, but there was no formalised system to ensure these were received and acknowledged by all clinical staff.
  • The service reviewed the effectiveness and appropriateness of the care provided through quality improvement activity such as clinical audits.
  • Clinicians had the skills, knowledge and experience to carry out their roles.
  • Clinicians understood the requirements of legislation and guidance when considering consent and decision making, although the nurses had not completed any Mental Capacity Act 2005 training.
  • There was no privacy screen or curtain in the consultation room for patients to use if needed to maintain dignity.
  • Patient feedback was positive about the service experienced and staff helped patients be involved in decisions about their care.
  • The service organised and delivered services to meet patients’ needs.
  • There was a clear leadership structure, and staff told us that they felt able to raise concerns and were confident that these would be addressed.
  • The service had a governance framework in place, which supported the delivery of quality care, and processes for managing risks, issues and performance.
  • There were systems and processes for learning, continuous improvement and innovation.

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

  • Ensure that all patients are treated with dignity and respect.
  • Ensure care and treatment is provided in a safe way to patients.

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 the system to ensure updates and best practice guidelines are received and acknowledged by all clinicians.
  • Review training requirements for all clinicians in relation to consent and the Mental Capacity Act 2005.
  • Review the process for checking and recording patient identification.