Our previous comprehensive inspection at the Isokinetic Medical Group on 3 May 2018 found breaches of regulations relating to the safe delivery of services. The full comprehensive report on the previous inspection can be found on our website at: www.cqc.org.uk/location/1-1686963441.

This inspection was an announced focused inspection carried out on 19 February 2019 to check that the service was meeting the regulations and to consider whether sufficient improvements had been made.

At this inspection, we found the service had made improvements. However, there were areas highlighted during the previous inspection where improvements are still required.

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

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.

Isokinetic Medical Group is an independent clinic in central London, which provides a sports and exercise medicine related healthcare service. The service offers services for adults and children.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. Therefore, we were only able to inspect the services provided by the doctors which included screening, assessment, diagnosis, follow-ups and referrals but not the osteopathy, physiotherapy, hydrotherapy and on-field rehabilitation services.

The managing 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.

Our key findings were:

• The service had demonstrated improvements in relation to calibration of clinical equipment, business continuity planning and fire safety risk assessment.
• Infection control audits had been carried out and a spill kit was available.
• We found some staff had not received training relevant to their role. However, we saw training sessions had been booked in the near future.
• We found most administrative staff had not received a formal appraisal within the last 12 months. The service informed us they had planned dates to complete appraisals in the near future.
• The service had not taken steps in a timely manner to ensure all necessary recruitment checks were in place and records kept in staff files including evidence of satisfactory conduct in previous employment in the form of references and health checks.

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.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 3 May 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.

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.

Isokinetic Medical Group is an independent clinic in the central London, which provides a sports and exercise medicine related healthcare service. The service offers services for adults and children.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. Therefore we were only able to inspect the services provided by the doctors which included screening, assessment, diagnosis, follow-ups and referrals but not the osteopathy, physiotherapy, hydrotherapy and on-field rehabilitation services.

The managing 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.

Twenty patients provided feedback about the service. Patients said they were satisfied with the excellent standard of person-centred care received and said the staff was approachable, committed and caring.

Our key findings were:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. There was a system in place for acting on significant events.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• Most risks were generally well managed though improvements were needed in relation to calibration of clinical equipment, business continuity planning and fire safety risk assessment.
• Safety systems and processes were in place although no infection control audits had been carried out.
• The service was unable to provide documentary evidence to demonstrate that all staff had received training relevant to their role.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Consent procedures were in place and these were in line with legal requirements.
• Systems were in place to protect personal information about patients.
• Appointments were available on a pre-bookable basis. The service provided only face to face consultations.
• Information about services and how to complain was available.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• There was a clear vision and strategy and staff spoke of an open and supportive culture.

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

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

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:

• Ensure all necessary recruitment checks are in place and records kept in staff files including evidence of satisfactory conduct in previous employment in the form of references and health checks.
• Review the fire safety risk assessment.
• Ensure persons employed in the provision of the regulated activity receive the appropriate training and appraisal necessary to enable them to carry out the duties.
• Review systems to verify a patient’s identity on registering with the service.