Harley Street Medical Centre (UME)

We have not previously rated the service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink. 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, and had access to good information. Key services were available to suit patients' needs.
• 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. All staff were committed to improving services continually.

However:

• All Patient Group Directions (PGDs) were signed by the appropriate staff, however, some of the paperwork associated with the PGDs was out of date. All 5 PGDs we saw they had all passed the expiry for review. Since inspection we have seen evidence that all nine PGDs used in the service have now been updated and signed appropriately.
• We found 2 out of date items including a cannula and some hydrocortisone gel.
• The key to the Fluoroscopy machine was left in the machine and accessible to untrained staff and patients. Since inspection the service has implemented a standard operating procedure to ensure the key is only held by specific staff and locked away at all other times.
• Several policies and guidance were past the review date and needed to be updated. Leaders were aware of this and had an action plan to address this.
• Weekly operations meeting were not minuted so some staff may not receive up to date information in unable to attend.