We carried out an announced comprehensive inspection at The London Centre on 9 May 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

This inspection was an announced comprehensive inspection which we undertook on 24 April 2019 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the issues identified in our previous inspection on 9 May 2018. This report found that the service had made improvements and is rated as good overall.

You can find the reports of our previous inspections by selecting the ‘all reports’ link for The London Screening Centre on our website at www.cqc.org.uk.

The London Screening Centre is a private doctors consultation service for adults delivered by a sole practitioner. The service mainly provides pre-employment health checks commissioned by private companies. On average, the provider sees 10 patients per week.

London Screening Centre is registered with CQC under the Health and Social Care Act 2008 to provide the regulated activities: diagnostic and screening procedures.

The provider 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.

We received five Care Quality Commission comment cards from patients who used the service; all were positive about the service experienced and reported that the service provided high-quality care.

Our key findings were:

• There was a comprehensive set of policies and procedures governing all activities.
• There was a complaints procedure in place and information on how to complain was readily available.
• Systems and processes were in place to keep people safe. The provider had undertaken adult and child safeguarding in line with intercollegiate guidance.
• The service had systems to manage risks, including a clear system to manage significant events and safety alerts.
• The provider was aware of current evidence based guidance and they had the skills, knowledge and experience to carry out his role.
• The service’s chaperones had received training and had a Disclosure and Barring Service (DBS) check undertaken by the provider.
• Comments cards indicated that patients were treated with compassion, kindness, dignity, and respect.
• The service carried out appropriate referrals to patients’ GPs when additional treatment was required.
• The service had systems in place to collect and analyse feedback from patients.

The areas where the provider should make improvements are:

• Explore opportunities for quality improvement activity within the service.
• Confirm the location of emergency equipment within the building.
• Ensure all patients are asked for consent to share details of their consultation with their registered GP.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 9 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 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 not 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.

The service mainly provides pre-employment health checks commissioned by private companies.

We received nine Care Quality Commission comment cards from patients who used the service; all were positive about the service experienced and reported that the service provided high-quality care.

Our key findings were:

• The service had some systems to manage risks, including a clear system to manage significant events and safety alerts. However, the service did not have an effective stock management system in place. Following the inspection the provider forwarded a comprehensive stock management policy.
• The service did not have adequate infection prevention and control arrangements in place.The service did not have an effective equipment calibration system in place. Following the inspection the provider demonstrated that the infection control processes had been adequately revised.
• The service offered a chaperone to patients who were undergoing intimate examinations. We found that persons used as chaperones by the service did not have chaperone training, or a Disclosure and Barring Service (DBS) check. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable). However, the chaperone did have an awareness of the requirements of the role. Immediately following the inspection the provider forwarded a DBS check undertaken by the chaperone.
• Comments cards indicated that patients were treated with compassion, kindness, dignity and respect.
• Information on how to complain was available and easy to understand.
• The service carried out appropriate referrals to patients’ NHS GP when additional treatment was required.
• The doctor had a vision to deliver high-quality care for patients.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service offered a flexible range of appointments and treatments.

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

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

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

We did not speak to people using the service as no appointments were booked at the time of the inspection. In recent patient feedback, when asked about "understanding of your problem" and "explanation of any investigations" the majority of people said they were "very satisfied". People described the service as "professional" and "friendly", and one person said that Dr Sadrudin was good at "fully answering my concerns". When asked about the friendliness of their welcome and the courtesy with which they were treated the majority of people said they were "very satisfied".

When people attended the service the assessments, examinations and diagnostic tests undertaken were governed by the health needs or health risks of the job and environment they were applying for. Dr Sadrudin had contacts with numerous specialists which people could be referred to if further investigations or treatment was required. In recent patient feedback people described the service as "very good", said they had a "very thorough examination" and that Dr Sadrudin was "very conscientious".

Dr Sadrudin knew about signs of possible abuse and the need to report any concerns he had. He had an annual appraisal with an external clinician and undertook appropriate training relevant to his role. People using the service were asked to provide feedback on their care and treatment. There was a complaints policy and procedure in place but at the time of the inspection no formal complaints had been received.