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Inspection carried out on 4 February 2014

During an inspection looking at part of the service

Our inspection of 29 September 2013 found that people were not adequately protected from the risk of unsafe or unsuitable equipment. This was because the provider did not always ensure resuscitation equipment was adequate, available and maintained. Specifically resuscitation equipment was available but the service did not have a defibrillator to help someone who had collapsed. This meant that people may not receive prompt emergency care and treatment to meet their needs.

We had found that there was no evidence of the local multi-agency safeguarding policies and procedures for either vulnerable adults or children. This meant that people were not protected from abuse because guidance about safeguarding people from abuse was not accessible to all staff.

We had also found that there were ineffective arrangements in place to demonstrate that staff were trained, competent and supported to provide safe and appropriate care to people. The provider wrote to us and informed us they would be complaint with the standards by 27 November 2003.

At this inspection we found the provider had ensured there was a defibrillator at the clinic so that people would receive prompt emergency treatment.

There was evidence multi-agency safeguarding procedures for vulnerable adults and children were available. This meant people were protected from abuse.

There were arrangements in place to demonstrate staff were competent and supported to provide suitable care to people.

Inspection carried out on 2 October 2013

During a routine inspection

People attended the clinic for consultations and treatment for urology conditions. Children were seen for consultations only by a specialist paediatric doctor.

We spoke to the two registered managers who jobshare and a member of staff. There were no people available to speak to at the time of the visit and as there were no clinics arranged for that day.

People who use the service were given appropriate information and support regarding their treatment.

Suitable arrangements were made for people with mobility difficulties to access the service.

A survey of people's views was examined. The results showed that people thought highly of the service. We saw that people had written, �Overall a very efficient and friendly service�.� and "X has been nothing short of fantastic."

The provision of appropriate resuscitation equipment and the arrangements for checking required review.

There was no copy of the local multi-agency safeguarding procedures.

There were ineffective arrangements in place to demonstrate that staff were trained, competent and supported to provide safe and appropriate care to people.

People's complaints were fully investigated and resolved, where possible, to their satisfaction. The complaints procedure was available to people in the waiting room and on the provider's website.