Archived: The Tonbridge Clinic

We carried out an announced desk based focussed inspection on 10 August 2018 to follow up on areas requiring improvement identified at the services earlier inspection conducted on 25 January 2018.

Our findings were:

Are services safe?

We found that this service was providing safe 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 provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines. The Tonbridge Clinic is registered to provide consultations and treatment in musculo-skeletal medicine. These services are provided by one medical practitioner in a designated consultation and treatment room within the clinic.

The clinic also provides osteopathy, physiotherapy, chiropody, acupuncture and other complementary treatments. These treatments are exempt by law from CQC regulation. Therefore, we were only able to inspect the treatment provided by the medical practitioner but not the other therapy services.

The medical practitioner 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.

We spoke with the practice manager and reviewed documentation to assess compliance with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Our key findings were:

• The provider had conducted pre-employment checks for administration and reception staff.

• The practice had access to a defibrillator and staff trained in its use.

• The practice had reviewed the accessibility of their complaints process and had revised their information leaflets which were available in their reception area.

• The practice had revised their governance structure to ensure the timely identification and management of risks. This included regularly reviewing and updating policies.

We carried out an announced comprehensive inspection on 25 January 2018 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 not 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 not 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 provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines. The Tonbridge Clinic is registered to provide consultations and treatment in musculo-skeletal medicine. These services are provided by one medical practitioner in a designated consultation and treatment room within the clinic.

The clinic also provides osteopathy, physiotherapy, chiropody, acupuncture and other complementary treatments. These treatments are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment provided by the medical practitioner but not the other therapy services.

The medical practitioner 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.

We asked for patients to complete CQC comment cards prior to the inspection. All of the 18 patient comment cards we received were positive about the service experienced. Of those, 14 specifically mentioned the treatment provided by the doctor and ten, the polite and helpful attitude of staff in reception. We also spoke with three patients at the time of the inspection. All three said they were happy with their care and would recommend the provider to friends and family.

Our key findings were:

• There was an open and transparent approach to safety with a systematic approach for reporting and recording significant events.

• Staff we spoke with demonstrated an understanding of their responsibilities regarding safeguarding. The doctor and the reception staff were trained in safeguarding children and vulnerable adults.

• The provider was unable to provide evidence to show that pre-employment checks for administration and reception staff had been carried out.

• There was medical oxygen and emergency medicines on the premises. There was no defibrillator.

• Patients’ notes were comprehensive. The provider ordered timely and appropriate investigations. These were followed up. Advice to patients was clear.

• Some reviews of the quality of care and outcomes of treatment were carried out. However, there was no formal programme of clinical audits.

• Staff told us the provider was approachable and always took the time to listen to members of staff.

• There was a policy for dealing with complaints. However, none had been received.

• There was an overarching governance structure. However, this had failed to identify and manage all risks or regularly review policies.

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

• 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.

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

• Review the information made readily available to patients regarding the complaints process.
• Review recruitment procedures to ensure only fit and proper persons are employed.