We carried out an announced comprehensive inspection on 3 October 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 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 were unable to assess this question due to the short time the clinic had been open.

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 not providing well-led care in accordance with the relevant regulations. The impact of our concerns, in terms of the safety of clinical care, is minor for patients using the service. Once the shortcomings have been put right the likelihood of them occurring in the future is low. We have told the provider to take action (see full details of this action in the Requirement Notices at the end of this report). We will be following up on our concerns to ensure they have been put right by the provider.

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.

Chingford Weightmedics is a slimming clinic located within a Dental Practice in North East London. Staff at the dental practice took responsibility for cleaning the clinic rooms and fire safety checks. The slimming clinic consists of a reception area and a first floor consulting room. It is close to local bus stops. Both Walthamstow tube and rail station and Chingford rail station are short bus rides away from the clinic. There is a public car park next door. The slimming clinic is not wheelchair accessible, however staff accommodated wheelchair users by using ground floor rooms when required.

The clinic is staffed by a receptionist and a doctor. A patient care manager can provide care to patients remotely. Staff usually based at other locations cover shifts at this clinic when required. If a shift is not filled by a regular doctor, locum doctors who are familiar with the clinic are contacted. In addition, staff work closely with other staff based at the head office in Richmond as well as the Victoria branch. This clinic is one of eight clinics run by the same provider organisation.

The Clinic Director is the registered manager. 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.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of weight reduction.

Our key findings were:

• The provider had systems in place to safeguard children and vulnerable adults from abuse.
• Patients at the clinic were provided with information to promote a healthy diet and exercise.
• The provider took account of patient needs and preferences and improved services in response to those needs.
• The provider learned, shared lessons, identified themes and took action to improve safety in the service.

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

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.

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

• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Review facilities for patients who may present with hearing and sight problems.
• Continue to collect patient feedback to inform the future judgement of the caring domain.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice