RAAM London Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture

At our last assessment, we rated this key question as Requires Improvement. At this assessment, the rating has changed to Good.

At our previous inspection we identified concerns about governance. For example, the service was not monitoring staff training or recruitment as outlined in its policies. It was not storing all patient confidential information securely and did not have effective processes in place for monitoring quality and improvement. At this assessment, we found that the service had reviewed governance systems. It had updated its policies and implemented associated systems and processes. These included systems to manage safety risks, monitor service quality and learn from incidents and feedback including complaints.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture.

Staff were aware of the service’s visions and values and how they applied to their roles and responsibilities.

Staff had the opportunity to contribute to discussions about changes within the service. For example, staff were encouraged to attend monthly meetings where updates were shared.

Clinical staff we spoke with said they received very good oversight and supervision from the lead doctor. Staff appraisals included conversations about career progression where relevant and development.

The service had inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation.

Staff told us leaders in the practice was approachable and responded to any concerns raised. Since our previous inspection, the service had recruited an experienced manager. Staff also told us that the manager had helped introduce clearer systems and processes and was always helpful if they had any questions.

The service fostered a positive culture where staff told us they could speak up and their voice would be heard. There was guidance for staff to follow and they were aware of how to raise concerns.

However, we noted that the service was not fully following ‘Freedom to speak up’ principles. (While this is not a requirement, some independent health organisations do so, for example, appointing an external person to whom staff can speak about any concerns.) Instead, staff were informed they could turn to other bodies, such as CQC, in the relevant policies.

The service valued diversity in the workforce. Policies and procedures to promote diversity and equality were in place. The service had conducted a staff survey the previous year. This showed that staff were positive about the service as a place to work and the quality of care they were able to provide.

The leaders had reviewed and revised governance and management arrangements since our previous inspection. There were now clearer responsibilities, roles, systems of accountability and governance which were shared with and understood by the staff team. The provider was able to demonstrate how it managed to deliver safe and effective treatment and support.

The provider had put in place governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers met with staff monthly to discuss updates, emerging risks, any relevant complaints and significant events and other forms of learning. They met individually to complete appraisals and performance reviews. There was also a general daily ‘huddle’ at which the team shared information about the day ahead and any issues.

Staff took patient confidentiality and information security seriously and had completed training on this.

The service understood their duty to collaborate and work in partnership when appropriate for example, to share relevant information with people’s usual GP (with consent) or in relation to people at risk of abuse.

The staff team understood the needs of particular groups of people using the service, for example, people travelling from abroad.

The service had a focus on continuous learning and improvement and this had improved since our previous inspection.

The service was proud of the range of services it offered. The lead doctor was a specialist in (relatively low risk) aesthetic surgical procedures to improve sexual health, function and confidence, some of which were not widely available elsewhere in the UK. They viewed themselves as a pioneer in this area of aesthetic medicine.

Service development was driven by a focus on improving outcomes and people’s experience. For example, the service had recently recruited a GP following feedback from people that they would like access to this type of independent service.

Since our previous inspection, the service had implemented a detailed quality improvement plan to address the concerns we identified at the previous inspection.

We saw evidence of improved management of risk including clear and comprehensive documentation of events, incidents and complaints. Governance systems had been reviewed and shared. Confidential information was now being stored securely in people’s electronic medical records. The service had introduced a programme of clinical and non-clinical audits to monitor quality. There remained scope to expand the use of clinical audit to monitor treatment outcomes.