We carried out an announced comprehensive inspection on 10 August 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.

M R Burrows Limited provides a private weight reduction service for adults in the Norwich area. Dietary advice, support and medicines are supplied to patients who use the service. The clinic is open on alternate Thursdays from 10.30 am to 5.30pm and on alternate Saturdays from 9am to 12pm. The service was located on the first floor of a beauty treatment salon.

M R Burrows operates as a franchise of National Slimming and Cosmetics Clinics who have 28 locations across the UK. The service in Norwich was staffed by two doctors, one female and one male and a manager who also operated as the receptionist. The manager 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 feedback from six patients through the collection of comments cards and speaking to patients during the inspection. All were very positive and found the service informative, helpful and the staff friendly and caring.

Our key findings were:

• Prescribing was in line with treatment protocols and comprehensive patient records were maintained securely.
• Patients were supported and they told us they found staff caring and understanding
• The premises were suitable and cleaned regularly

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
• Ensure there is a robust system in operation for the dissemination of patient safety alerts and be able to demonstrate its effectiveness
• Have an effective documented system in place for dealing with medical emergencies

We reviewed six individual consultation and treatment records. These showed us that people had been involved in discussions regarding their individualised treatment and had given their written consent. This showed us that people’s privacy, dignity and independence were respected.

The records seen showed us that each person had an initial consultation,during which, a medical history had been obtained. People’s identities had been verified and their height, weight and resultant body mass index (BMI) were recorded. This meant that individual care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

The evidence seen showed us that systems and processes were in place to ensure that people receive their dispensed medicines in a safe manner. This demonstrated to us that the provider had appropriate arrangements in place to manage medicines.

Information about raising concerns was displayed in the clinic and was available within the clinic’s information leaflet. This leaflet was given to each person at their first consultation. This showed us that the provider had an effective complaints system available.

The individual treatment records were accurate and reflected each treatment consultation received. This demonstrated to us that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We saw that three monthly audits were carried out by the provider to check that the consent process had been appropriately followed and the results seen showed us that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We saw that each person had an initial consultation during which their identification was verified and height, weight and resultant body mass index (BMI) recorded. This showed us that people experienced care, treatment and support that met their needs and protected their rights. We saw records that showed us that a letter was given to each person who was having treatment and that people were encouraged to give this to their General Practitioner. This demonstrated to us that the provider worked in co-operation with other primary healthcare providers.

Six weekly medicines audits were carried out and the findings seen showed us that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. The provider had carried out three monthly audits on consent to care, treatment records and any complaints received. The service had not received any formal complaints in the past year. Actions had been recorded where any concerns had been identified. This showed us that the provider had an effective system to regularly assess and monitor the quality of service that people receive.