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Inspection carried out on 2 October 2019

During a routine inspection

134 Harley Street is operated by Harley Street Fertility Clinic. The service has no overnight beds. Facilities include one operating theatre, outpatient and diagnostic facilities. The service provides surgical procedures.

We inspected surgery.

We inspected this service using our comprehensive inspection methodology.

We carried out an unannounced inspection on 2 October 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this hospital/service stayed the same. We rated it as Good overall because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and gave them access to good information. Key services were available six days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to continuously improving services.

However, we also found the following issues that the service provider needs to improve:

  • The safeguarding policy did not reflect most recent national best practice guidance. This was action we had previously told the provider to take on our last inspection.
  • The service could not be assured that staff always controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection, but these were not always consistently used or reliable. Not all staff at the service were bare below the elbow, and leaders had not completed the action plan from the most recent infection prevention and control audit.
  • We found one instance where the disposal of a controlled drug was not recorded correctly.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (South & London)

Inspection carried out on 16 December 2016

During an inspection looking at part of the service

134 Harley Street is operated by Harley Street Fertility Clinic. The service has no overnight beds. Facilities include one operating theatre, outpatient and diagnostic facilities.

The service provides surgical procedures

We inspected surgery.

We inspected this service using our comprehensive inspection methodology.

We carried out an announced inspection on 19 December 2016.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Services we rate

We rated this service as good overall.

  • There were good systems and processes in place to protect patients from avoidable harm.

  • Reporting of incidents was encouraged and the process was understood by staff.

  • The environment was visibly clean and well maintained and there were measures to prevent and control the spread of infection.

  • There were adequate numbers of suitably qualified, skilled and experienced staff to meet patients’ needs, and staff had access to training and development, which ensured they were competent to do their jobs.

  • There were arrangements to ensure patients had access to suitable refreshments, including drinks.

  • Treatment and care was delivered in line with national guidance and the outcomes for patients were good.

  • Patient consent for treatment and care met legal requirements and national guidance.

  • Patients could access care in a timely way, and had choices regarding their treatment day.

  • Staff ensured patients privacy and the dignity of patients was upheld.

  • The leadership team were visible and appropriate governance arrangements meant the service continually reviewed the quality of services provided.

We found areas of practice that require improvement in surgery:

  • The service should review its process for managing the identification of out of date drugs.

  • The service should also review its surgery safety checklist policy, so that it reflects best practice guidance, including the World Health Organisation surgical checklist.

  • Safeguarding policy was not in line with the intercollegiate guidance.

Prof Ted Baker

Deputy Chief Inspector of Hospitals