Thurmaston Health Clinic

This service is rated as Inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at Thurmaston Health Clinic as part of our inspection programme.

Thurmaston Health Clinic offers private clinic services specialising in Women’s Health and Wellbeing including treatment of menopause and vaginal rejuvenation.

This service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Thurmaston Health Clinic provides a range of non-surgical cosmetic interventions, for example cosmetic injectables, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Emma Soos 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.

Our key findings were:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice responded to patients’ needs and treated patients holistically.
• The service offered educational sessions to promote women’s health and improve awareness of aspects of women’s health.
• There was a lack of oversight from management within the service in relation to premises, infection control and training and recruitment.
• Policies were not adapted to the specific characteristics of the service and did not give assurance that staff were working to the same standards to keep patients safe.
• The provider did not arrange interviews for us to speak with staff throughout the inspection.
• Roles and responsibilities were not clear including who worked for the service and what their involvement was.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Undertake audits within the service which evidence improvements to the service.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care