• Doctor
  • Independent doctor

Archived: The Smart Clinics Brompton Cross

Overall: Good read more about inspection ratings

13 Crescent Place, London, SW3 2EA (020) 7681 1153

Provided and run by:
Smart Medical Clinics Limited

Important: This service is now registered at a different address - see new profile
Important: This service is now registered at a different address - see new profile

All Inspections

19 June 2019

During a routine inspection

This service is rated as Good overall. (Previous inspection 05 2018)

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 at The Smart Clinics Brompton Cross on 19 June 2019 as part of our inspection programme, and to rate the independent doctors aspect of the service for the first time. General dental services are also provided at The Smart Clinics Brompton Cross, which we also inspected on the same day as this inspection, but which are reported on separately as that aspect of the service is not being rated.

The two service managers are the registered managers. One of the registered managers is currently on long term absence. 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.

Fifteen people provided feedback about the service by completing comments cards, which we made available in the practice two weeks prior to our inspection and on the day of our inspection itself. Their comments were all positive about their care and treatment experiences, reception staff and clinicians being helpful and treating them with care. We also received four patient feedback responses through the Share Your Experience area of our website about The Smart Clinics Brompton Cross since this inspection was announced. These were also all positive and had similar themes to the comments cards completed at the service, such as a good care and treatment, a prompt and convenient service, and that the service was provided in a clean environment.

Our key findings were:

  • There were arrangements to keep people safe and safeguarded from abuse. However, some areas need further review; particularly management of medicines, staff training, infection prevention and control arrangements and clinical waste management.
  • The service undertook clinical and non-clinical quality improvement activities in the independent doctors’ service.
  • Patient feedback we received indicated people were totally satisfied with their care and treatment experiences and raised no concerns or complaints about the independent doctors service.
  • We found that complaints were appropriately managed.
  • The facilities and premises were appropriate for the services offered.
  • There were clear responsibilities, roles and systems of accountability to support good management.

The areas where the provider must make improvements as they are in breach of regulations 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:

  • Records checks of medicines and equipment for treating medical emergencies to provide assurances they are fit for purpose.
  • Provide appropriate notifications and information to people using and accessing the service for the use of closed-circuit television (CCTV) in common areas.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

19 June 2019

During a routine inspection

We carried out this announced inspection on 19 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

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

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

The Smart Clinics Brompton Cross is in the London Borough of Kensington and Chelsea and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Limited car parking spaces are available near the practice for a fee.

The dental team includes two dentists, (one of whom is the principal dentist) a trainee dental nurse, a receptionist and a practice manager. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at The Smart Clinics Brompton Cross is the practice manager.

We received feedback from nine patients.

During the inspection we spoke with both dentists, the trainee dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Our key findings were:

  • The practice appeared clean and well maintained, however some cleaning equipment was in need of replacement.
  • The provider had infection control procedures which reflected published guidance. However, a single use instrument was reportedly being reused on the same patient.
  • The practice systems to help them manage risk to patients and staff needed improving. There was no legionella risk assessment and sharps risk assessment in place.
  • Staff knew how to deal with emergencies. Appropriate medicines and most life-saving equipment were available.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Staff were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • There was lack of effective leadership. The last infection control audit undertaken for continuous improvement was not appropriate for use in a dental practice.
  • Staff felt involved and supported and worked well as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had effective information governance arrangements

We identified regulations the provider was not complying with. They must:

  • Ensure that care and treatment is provided to patients in a way that is safe
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider was not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

  • Review the practice's protocols for medicines management and ensure all medicines are dispensed safely and containers are clearly labelled with the practice details.

1 May 2018

During a routine inspection

We carried out an announced comprehensive inspection on 1 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 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.

Prior to our inspection, patients completed CQC comment cards telling us about their experiences of using the service. Eleven people provided feedback about the service, all of which was positive about the care and treatment experiences, and the prompt access to services.

Our key findings were:

  • When incidents happened, the service learned from them and improved.
  • The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Services were provided to meet the needs of patients.
  • Patient feedback about the services provided was consistently positive.
  • There were clear responsibilities, roles and systems of accountability to support good management.
  • The service’s systems to manage risks had not suitably addressed infection prevention and control risks, ensured suitable arrangements for dealing with medical emergencies or responding to patient safety alerts.

We identified areas where the service could improve and should:

  • Review arrangements to ensure the infection prevention and control (IPC) arrangements in the dental service are in line with published guidelines.
  • Review their current stock of medicines for treating medical emergencies to ensure they are in line with published recommendations.
  • Review their safeguarding children and young people policy to reflect additional current topics of concern and their adult safeguarding policy to reflect the correct local contacts for escalating concerns.
  • Review the functionality of their records system to ensure they can systematically search records and verify the relevance of medicines and safety alerts to their patient population.
  • Demonstrate quality improvement through follow up audit cycles.
  • Review their arrangements for reviewing and where necessary acting on safety alerts including patient, medicine and device safety alerts.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice