This service is rated as
Requires improvement
overall.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
We carried out an announced comprehensive inspection at First Health Medical and Skin Care Centre as part of our inspection programme and to provide a rating for the service. The service was last inspected on 23 May 2018, and was found to be meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 but there were some areas where we identified the provider could make improvements.
The service provides general practice services, including travel vaccination and family planning. It also provides medical treatment for a number of skin conditions and minor surgery (e.g. to remove moles, warts and cysts).
The service provides general practice services, including travel vaccination and family planning. It also provides medical treatment for a number of skin conditions and minor surgery (e.g. to remove moles, warts and cysts).
This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. First Health Medical and Skin Care Centre also offers a range of aesthetic services not regulated by CQC including Botox and laser hair removal.
The lead GP 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 spoke to one patient during the inspection and looked at feedback collected by the service.
Our key findings were:
- The service did not have clear systems to keep people safe and safeguarded from abuse.
- Systems to assess, monitor and manage risks to patient safety were not consistently effective.
- Medicines and equipment to deal with medical emergencies were not monitored effectively to ensure that they were available and effective when required.
- There were gaps in records used to demonstrate that staff had the skills and knowledge to carry out their roles.
- The service was not actively involved in clinical quality improvement activity.
- Systems to support good governance and management were not clearly set out or effective.
- There was limited evidence of learning, continuous improvement and innovation.
- From the records we reviewed, staff prescribed medicines to patients and gave advice on medicines in line with legal requirements and current national guidance.
- Individual care records were written and managed in a way that kept patients safe. The care records we saw showed that information needed to deliver safe care and treatment was available to relevant staff in an accessible way.
- Patients said they were treated with care, compassion, dignity and respect.
- The service took account of patients’ needs and preferences, and had made adjustments to allow access.
- There was a clear leadership structure and staff felt supported by 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.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
- Update the complaints leaflet available for patients to ensure the information provided is correct.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care