Cardiac Screen Limited

Updated 28 November 2022

Cardiac Screen Limited is an independent clinic in South East London.

Services are provided from: The Medical Specialists, Balppa House, 57-61 Newington Causeway, London, SE1 6BD. We visited this location as part of the inspection on 07 September 2022.

Cardiac Screen Limited is a private service, specialising in complete heart screening procedures. They also offer services related to gynaecology and psychiatry. On average the service offers 21 appointments per month with cardiologists, 40 with a gynaecologist and 16 with a psychiatrist.

The service offers health screening to taxi drivers, racing drivers and pilots.

The service was open to children (14+ years old) and adults.

Online services can be accessed from the practice website: www.cardiacscreen.co.uk

The team consists of two directors, four cardiologists, one gynaecologist, one psychiatrist, one psychologist and two part time reception staff. One of the directors is working as a clinic manager, cardiac physiologist and a CQC registered manager. The second director is working as a part time receptionist at the service.

The service is registered with the Care Quality Commission to provide the regulated activity of diagnostics and screening procedures and treatment of disease, disorder or injury.

How we inspected this service

Pre-inspection information was gathered and reviewed before the inspection. We spoke with both directors. We looked at records related to patient assessments and the provision of care and treatment. We also reviewed documentation related to the management of the service. We spoke to a patient and reviewed patient feedback collected by the service.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 28 November 2022

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 Cardiac Screen Limited as part of our inspection programme.

Cardiac Screen Limited is a private service, specialising in complete heart screening procedures. They also offered services related to gynaecology and psychiatry.

The senior cardio physiologist 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.

For reasons of safety and infection prevention and control related to the COVID-19 pandemic, we did not commission patient feedback with CQC comment cards. We spoke with two patients during this inspection and received positive feedback.

Our key findings were:

• There was a lack of good governance and limited evidence of quality improvement activity to review the effectiveness and appropriateness of the care provided.
• Recruitment checks were not always carried out in accordance with regulations including Disclosure and Barring Service (DBS) checks.
• The service did not have systems in place to assure that an adult accompanying a child had parental authority.
• The service did not have reliable systems for the appropriate and safe handling of medicines to ensure safe prescribing.
• Prescribing was not audited or reviewed to identify areas for quality improvement.
• The performance of doctors was not monitored and the service was unable to provide assurance that the consultations of all doctors were undertaken in line with relevant national UK guidelines.
• Clinical audits were not carried out.
• A formal infection control audit was not carried out.
• The service acted on and learned from some safety alerts related to diagnostic equipment. However, medicine safety alerts were not received and shared with clinicians internally.
• A fire risk assessment and legionella risk assessment were not carried out.
• Safeguarding lead we spoke with demonstrated lack of understanding of the Gillick competency test.
• Some policies did not include sufficient information. The medicines management policy was not available. Most of the policies did not include the name of the author and they were not dated.
• The service was unable to provide documentary evidence to demonstrate that all staff had received formal safeguarding children training, safeguarding adult training, infection control training and fire safety training relevant to their role.
• Annual appraisals were not always carried out regularly.
• The service organised and delivered services to meet patients’ needs.
• Patients were able to access care and treatment in a timely manner.

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.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

The areas where the provider should make improvements are:

• Organise sepsis awareness training.
• Carry out health and safety risk assessments, organise fire drills and inspect emergency lighting.
• Carry out a formal infection control audit.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services