Archived: London Prevention Clinic

We previously carried out an announced comprehensive inspection of London Prevention Clinic on 19 April 2018 and found that the service was in breach of Regulation 12: ‘Safe care and treatment’ and Regulation 17: ‘Good governance’ of the Health and Social Care Act 2008. In line with the Care Quality Commission’s (CQC) enforcement processes we issued two warning notices which required London Prevention Clinic to comply with the Regulations by 15 June 2018.

We then carried out an announced focused inspection of London Prevention Clinic on 19 June 2018 and found that the service remained in breach of Regulation 12 and Regulation 17. We issued two warning notices which required London Prevention Clinic to comply with the Regulations by 17 August 2018.

The full reports of the 19 April 2018 and 19 June 2018 inspections can be found by selecting the ‘all reports’ link for London Prevention Clinic on our website at www.cqc.org.uk.

We carried out this focused 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 now meeting the Regulations of the Health and Social Care Act 2008.

The previous inspection on 19 June 2018 identified areas where the provider had not complied with Regulation 12: ‘Safe care and treatment’. We found:

• Patient records were not written and managed in a way that kept patients safe and we saw evidence of inappropriate prescribing.
• There was no system to ensure medicines or safety alerts were recorded, discussed and acted upon by staff.
• Not all clinical staff had enhanced disclosure and barring service (DBS) checks.

The inspection on 19 June 2018 also identified areas where the provider had not complied with Regulation 17: ‘Good governance’. We found:

• Some policies were not specific to the service, as they identified individuals who did not work for the service and outlined processes which were not actually in place.

At this inspection on 17 September 2018 we found that although the provider had taken some action in relation to the provision of safe, effective and well-led care, there were still breaches of the Regulations.

Our key findings were:

• All clinicians had enhanced disclosure and barring service (DBS) checks.
• The system to ensure safety alerts were recorded, discussed and acted upon was not effective.
• Patient records were not written and managed in a way that kept patients safe.
• We saw instances where the service was not delivering care and treatment in line with current evidence based guidance.
• The service had commissioned an external company to produce new policies. However, some policies were missing and others were not fit for purpose or did not contain adequate information.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.

The CQC identified breaches of Regulation 12 which gave us serious concerns. The provider has agreed to cease carrying out regulated activities until further notice and the CQC will continue to monitor the service and assess the need for further enforcement action.

We previously carried out an announced comprehensive inspection of London Prevention Clinic on 19 April 2018 and found that the service was not providing safe, effective or well-led care and was in breach of Regulation 12: ‘Safe care and treatment’ and Regulation 17: ‘Good governance’ of the Health and Social Care Act 2008. In line with the Care Quality Commission’s (CQC) enforcement processes we issued two warning notices which required London Prevention Clinic to comply with the Regulations by 15 June 2018. The full comprehensive report of the 19 April 2018 inspection can be found by selecting the ‘all reports’ link for London Prevention Clinic on our website at www.cqc.org.uk.

We carried out this focused 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 now meeting the Regulations of the Health and Social Care Act 2008.

The previous inspection on 19 April 2018 identified areas where the provider had not complied with Regulation 12: ‘Safe care and treatment’. We found:

• Patient records were not written and managed in a way that kept patients safe.
• There was no evidence the service reviewed and acted upon medicines safety alerts.
• The service did not have all the required medicines or equipment to use in a medical emergency and there was no evidence that regular checks of emergency medicines were completed.
• Some staff members, including clinical staff, had not had an enhanced disclosure and barring service (DBS) check.
• There was no evidence that staff had received training to carry out the activities they were undertaking at the service, for example three members of clinical staff in relation to basic life support training, the sonographer in relation to mammograms and one of the doctors in relation to cervical smear tests.

The inspection on 19 April 2018 also identified areas where the provider had not complied with Regulation 17: ‘Good governance’. We found:

• The service had not completed any quality improvement activity, such as clinical audits.
• There was no method to audit prescribing as prescriptions were not attached to patient records or retained on the computer system.
• There was no system to check that clinical staff had professional indemnity insurance and there was no evidence of professional indemnity insurance for some clinical staff.
• The fire safety processes were not effective. No fire drills had been carried out and there was no evidence of fire alarm tests and fire extinguisher checks.
• Many policies were not specific to the service, as they identified individuals who did not work for the service as leads in certain areas, and outlined processes which were not actually in place for the service.

At this inspection on 19 June 2018 we found that the provider had taken some action in relation to the provision of safe, effective and well-led care, however there were still breaches of the Regulations.