Four18 Wellbeing

We carried out an announced focused inspection at Four18 Wellbeing on 27 February 2023. Following our review of the information available to us, including information provided by the service, we focused our inspection on the key question safe. Due to assurances we received from our review of information, we carried forward the ratings for the key questions effective, caring, responsive and well-led from our last inspection in September 2022. Overall, the service is rated as good. It is rated as good in safe, effective, caring, responsive and well-led.

Following our previous inspection on 12 September 2022, the service was rated good overall and in effective, caring, responsive and well-led. It was rated requires improvement for the key question safe. The full reports for previous inspections can be found by selecting the ‘all reports’ link for Four18 Wellbeing on our website at www.cqc.org.uk

We carried out an announced focused inspection at Four18 Wellbeing to follow up on a breach of regulation regarding fit and proper persons employed. We also followed up on 5 best practice recommendations:

• Check patient identity including that of any person that accompanies a child for treatment, aged 16 or under who does not pass the Gillick test, to establish parental responsibility.
• Complete a risk assessment to mitigate potential risks to patients where staff have not received hepatitis B immunisation.
• Put in place an action plan to act on the findings of the legionella risk assessment.
• Act on plans to carry out clinical audits and patient surveys to drive quality improvements within patient care.
• Carry out appraisals for all staff members.

The Care Quality Commission inspected the service on 27 February 2023 to ensure the provider had made improvements regarding the breach of regulation and 5 best practice recommendations. We checked these areas as part of this focused inspection and found that the breach of regulation had been resolved. We found that 4 of the 5 best practice recommendations had been addressed however, clinical audits and patient surveys had not been completed.

Four18 Wellbeing provides a range of private GP services.

Four18 Wellbeing 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. Four18 Wellbeing provides a range of non-surgical cosmetic interventions which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Dr Tayyab Bhatti is the registered manager. A registered manager is a person who is registered with the CQC 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:

• Staff files had been updated to include the required recruitment documentation.
• A system to check patient identity including that of any person that accompanied a child for treatment had been put in place to establish parental responsibility.
• A risk assessment to mitigate potential risks to patients where staff have not received hepatitis B immunisation had been completed.
• An action plan to act on the findings of the legionella risk assessment was put in place immediately after our inspection.

We also followed up on 2 shoulds not covered in the safe question and found that:

• An appraisal for the receptionist had been completed.
• Clinical audits and patient surveys to drive quality improvements within patient care had not been completed due to small patient numbers. The provider had plans in place to complete an audit of patients provided with hay fever treatment over the summer period.

The areas where the provider should make improvements are:

• Act on plans to carry out clinical audits and patient surveys to drive quality improvements within patient care.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services