This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of Sunnah Circumcision Service at Maryam Centre on 13 April 2019 as part of our inspection programme.

We had previously carried out an announced comprehensive inspection of the service on 4 November 2017 and found that it was compliant with the relevant regulations.

Sunnah Circumcision Service at Maryam Centre is an independent health service located in the London borough of Tower Hamlets, providing non-therapeutic male circumcision.

Our key findings were:

• The service had not recorded two incidents as significant events, although both were handled appropriately.
• On the day of inspection, we found some gaps in safeguarding and basic life support training.
• The service did not have an adequate process in place to verify patients’ identities, including checking that adults attending with children had parental responsibility and documenting this.
• We identified some infection control risks during the inspection, although the provider took prompt action to address these.
• The service was aware of and complied with the requirements of the duty of candour.
• Care and treatment was delivered according to relevant and current evidence based guidance and standards.
• The service reviewed and monitored the effectiveness of the treatment provided.
• Patient feedback about the service was positive.
• The service organised and delivered services to meet patients’ needs. Patients could access the service in a timely way.
• There was a clear leadership structure and staff told us they were supported and felt able to raise concerns.

The areas where the provider must make improvements are:

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

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Ensure formal complaints outcome letters are sent.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 4 November 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.

The Sunnah Circumcision Service at Maryam Centre is located in the London borough of Tower Hamlets and provides private health services. The services offered were faith and non-faith based cultural circumcision services for all age groups, including adults. The patients seen at the practice are often seen for single treatments and as such the clinic does not keep a patient list.

The services doctor 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.

As part of our inspection we also asked for CQC comment cards to be completed by patients prior to our inspection. We received 95 comment cards which were all positive about the standard of care received. Patients said they felt the provider of services at the offered an excellent service and staff were helpful, caring and treated them with dignity and respect.

Our key findings were:

• There was an effective system in place for reporting and recording significant events.
• Risks to patients were always assessed and managed, the service held emergency drugs and had conducted a risk assessment for the omission of emergency equipment.
• The clinic had a number of policies and procedures to govern activity.
• The clinic had an infection control policy and had carried out an audit but this was not service specific.
• Electrical equipment had been portable appliance tested (PAT).
• 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.
• The clinic had good facilities and was well equipped to treat patients and meet their needs.
• The clinic proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

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

• Carry out a service specific infection control audit.