The Care Quality Commission
  • Residential substance misuse service

10 Harley Street

Overall: Requires improvement read more about inspection ratings

10 Harley Street, London, W1G 9PF

Provided and run by:
A&A Consulting Limited

All Inspections

27 September 2022

During a routine inspection

A&A Consulting Limited, which is based at 10 Harley Street, provides a nurse-led alcohol detoxification service for people in their own homes.

We rated this service as requires improvement.

The service was not working with any clients and there had been only one recent client.

We found the following areas where improvement was needed:

  • The service did not have adequate governance arrangements in place and did not display an understanding of what was required. Without good governance systems and appropriate policies in place, a service cannot monitor the delivery of quality care or continuously improve the quality of their services. We saw poor governance arrangements in relation to the recording of safe staff recruitment, lone working, transportation of medicines and information containing personal information, ensuring detailed care records and the proper maintenance of medical equipment used in care.
  • The service did not evidence that they made reasonable effort to gather necessary information from a clients GP before starting treatment. This meant all physical health risks may not be known to the staff in order to inform safe treatment.
  • Care and treatment records did not include all necessary information relating to the patient’s care. For example, reason for the admission, relapse prevention plans or evidence of daily physical health checks.
  • There was no system in place to support patients to make a complaint and no information available about how to do this.

We found the following areas of good practice:

  • The registered manager accessed criminal record check information when he employed someone, in line with safe recruitment practices.
  • There were clear inclusion and exclusion criteria for clients who wanted to access treatment from the service.
  • The client we spoke with described compassion and kindness from the service and felt well-informed about their treatment plan.

28 March 2019

During a routine inspection

We carried out an announced comprehensive inspection on 28 March 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.

10 Harley Street is a service for adults and carries out home detoxification of alcohol, the services they provide includes:

  • Telephone assessment.
  • Liaison/collaborating with GP or other primary care services.
  • Face to Face assessment with responsible adult.
  • Prescription of medication.
  • Home visits, telephone support and monitoring for the duration of the detox.

Mr Anthony Jemmott (Registered Nurse) is the registered manager. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This service is registered with CQC under the Health and Social Care Act 2008 for the regulated activities of Treatment of disease, disorder or injury.

Our key findings were:

  • Systems and processes were in place to keep people safe. The service lead was the lead member of staff for safeguarding and had undertaken adult safeguarding to level two and child safeguarding training to level three. Whilst the provider did not directly provide clinical services for patients under 18 there is an expectation that staff working in a health care setting are trained in child safeguarding in line with the intercollegiate guidance.
  • The provider was aware of current evidence based guidance and they had the skills, knowledge and experience to carry out his role.
  • The provider was aware of their responsibility to respect people’s diversity and human rights.
  • Patients were able to access care and treatment from the clinic within an appropriate timescale for their needs.
  • There was a complaints procedure in place and information on how to complain was readily available.
  • Governance arrangements were in place. There were clear responsibilities, roles and systems of accountability to support good governance and management.
  • The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and 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 had systems in place to collect and analyse feedback from patients.

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

  • Review the process for gathering and analysing patient feedback.
  • Review the quality improvement activity and introduce two cycle clinical audits.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care