We carried out a focussed inspection on 7 November 2018 to ask the service the following key question; Is the service well-led?

Our findings were:

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.

CQC previously inspected this service on the 20 February 2018 and asked the provider to make improvements regarding the well led aspect of the service. We checked this as part of this focussed inspection and found that this had been resolved.

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. At National Slimming and Cosmetic Clinics – Hounslow the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment for weight reduction but not the aesthetic cosmetic services.

The clinic 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.

Our key findings were:

• The provider had established effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

• The provider had appropriate training records to evidence that staff had the necessary skills and competence to carry out their roles.

• The provider provided evidence of regular appraisals for all staff working in the service.

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

• Continue to review the need for chaperoning at the service .

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 20 February 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.

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.

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. At National Slimming and Cosmetic Clinics – Hounslow the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment for weight reduction but not the aesthetic cosmetic services.

National Slimming and Cosmetic Clinics – Hounslow is a private slimming clinic. The clinic is on the third floor accessed by stairs. The clinic is comprised of a reception area and two consulting rooms. The clinic was open on Monday from 3.30pm to 6.30pm, Tuesday Wednesday and Friday from 10am to 2pm and Saturday from 9.30am to 1pm. The clinic was closed on Thursday and Sunday. The clinic provides advice on weight loss and prescribed medicines to support weight reduction.

Staff included a clinic manager, a receptionist and three doctors. A locum doctor was working on the day of our visit. The registered manager was not currently working at the service. 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.

19 people provided feedback on the service via CQC comment cards, all of the comments on the service provided and the staff were positive.

Our key findings were:

• Staff told us they enjoyed their work and were supported to carry out their roles and responsibilities.
• Patient feedback was positive about their experiences at the clinic.
• The provider had systems in place to monitor the quality of the service being provided.

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:

• Review the necessity for chaperoning at the service and staff training requirements if necessary.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Review the appropriateness of using family members for translation.