We carried out a comprehensive inspection on 20 June 2017 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 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 providing well-led care in accordance with the relevant regulations.

Background

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 service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Gold image limited provides weight loss treatment and services, including medicines and dietary advice to patients accessing the service. It is part of National Slimming and Cosmetic Clinics, with locations across the country. We carried out a comprehensive inspection at the location in Ilford on 20 June 2017. The service comprises of a reception, office areas, waiting room and clinical rooms. A toilet facility is available on the clinic premises. There were three doctors, a clinic manager, and a receptionist employed at the service. The clinic is on the ground floor in a central shopping location. The clinic is open from 10am – 2pm on Mondays, 10am – 8pm on Tuesdays to Fridays and 10am – 5pm on Saturdays.

The clinic had a registered manager in post. 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 received feedback about the clinic from 36 completed comment cards. The observations made on the comment cards were all positive and reflected that patients found staff to be helpful, encouraging, supportive and caring.

Our key findings were:

• We found the service had good governance systems and quality assurance processes in place although these were not always used to drive improvement in patients care.
• The feedback we received from patients was consistently positive about the care they received.
• There were defined and embedded systems, procedures and processes to keep patients protected and safeguarded from abuse.
• There were systems and processes in place to monitor and improve the quality of services being provided.
• There were appropriately qualified staff in the clinic and staff felt supported to carry out their roles and responsibilities.

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

• Review how information is shared with other providers for those that had given consent, in order to keep people safe.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Review the necessity for chaperoning at the service and staff training requirements if necessary
• Review safeguarding policy to clarify the safeguarding lead.
• Review how clinical effectiveness is audited.

Medicines were prescribed and given to people appropriately. Medicines were safely administered.

Appropriate checks were undertaken before staff began work.

People who used the service were given appropriate information and support regarding their care or treatment. They understood the care and treatment choices available to them. One person said "I was given information about the medications to be prescribed".

People’s needs were assessed and treatment was planned and delivered in line with their individual treatment plan. One person said, "I wouldn't go anywhere else. I know I'm getting suitable treatment and being looked after and well monitored". The provider should note that people's progress towards their targets should be monitored regularly to ensure the treatment remains effective and appropriate.

Records showed that people were not given breaks from the prescribed medicines at appropriate intervals. This meant people were at increased risk of developing serious side effects from the medicines they were taking.

The service did not always operate safe recruitment procedures. Aappropriate checks had not been undertaken in all cases before staff began work. This meant there was a risk that people received support from staff who were not of good character.

There was an effective complaints system available. The service had not received any formal complaints recently, however people we spoke with said if they had any complaints they felt comfortable to raise them with any of the staff. They said they believed any complaints would be taken seriously and resolved by the service.

People who use the service were given appropriate information and support regarding their care or treatment. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People who use services were happy with the service provided but they were not always clear about the medication treatment that they were taking. They were treated with dignity and respect and provided with privacy. The premises were clean and there was regular monitoring of hygiene standards. Staff were appropriately trained and supported to provide care and there was good management oversight of the clinic.