This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out this announced comprehensive inspection at Brixton Clinic on 6 April 2019. We had previously carried out an announced comprehensive inspection on 24 January 2018. At that time the service was judged to be meeting the standards for providing effective, caring, responsive and well led care and treatment and not providing a safe service..

The area where we said that the provider must make improvement was:

• Retain a copy of the operative notes that are given to patients, and ensure that the operative note is also forwarded by the service to the NHS GP where known.

The area where we said the provider should make improvements was:

• Review infection control procedures including those in relation to risk assessments and the provision of guidance and cleaning procedures available for domestic staff.

At this inspection we found that the practice had addressed all of the issued from the previous inspection. However, we noted that there were other breaches in the safe and effective domains.

We found that:

• The service provided care in a way that kept patients safe and protected them from avoidable harm in most areas. However, the service did not have systems in place to ensure that all risks to patients were mitigated, and did not report safeguarding concerns in line with guidance.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The service organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We identified a regulation that was not being met and the provider must:

• Ensure care and treatment is provided in a safe way to patients.

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

• Develop a quality improvement program.
• Undertake proactive patient surveys.
• Provide further safety netting information in post-operative checklists that are given to patients.
• Implement more regular reviews of policies.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 24 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 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.

Our key findings were:

• The clinic had systems in place to manage significant events.
• Risks to patients were not always assessed and managed. The clinic held emergency medicines, and oxygen was ordered following the inspection.
• Consent was taken by both parents prior to commencing the procedure, including checking documents to confirm identification.
• Policies and procedures were in place to govern all relevant areas.
• The clinic had an infection control policy and had carried out an audit but this was based on infection rates from procedures only. Although clean, the practice did not have a checklist which the cleaners should follow.
• The doctor assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Written information was provided to the parents of patients detailing how to care for the patient following surgery.
• The clinic had good facilities and was well equipped to treat patients and meet their needs.
• The clinic sought feedback from patients, but in the past year only one patient had provided feedback, this was positive.
• The clinic was aware of and complied with the requirements of the Duty of Candour.

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

• Retain a copy of the operative notes that are given to patients, and ensure that the operative note is also forwarded by the service to the NHS GP where known.

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

• Review infection control procedures including those in relation to risk assessments and the provision of guidance and cleaning procedures available for domestic staff.