LMCS Limited

Updated 26 October 2021

LMCS Limited is situated at 78 Beverley Drive, Edgware, HA8 5NE. It operates as a private circumcision clinic which carries out circumcisions on male babies, children and adults. The clinic carries out up to 50 circumcisions a month.

There are two male circumcision practitioners, a male assistant and five part-time reception staff. One of the practitioners is a doctor registered with the General Medical Council (GMC) who carries out therapeutic and non-therapeutic circumcisions and the second is a dentist registered with the General Dental Council (GDC) who carries out non-therapeutic circumcisions only. Both have had surgical training. Both are members of the Royal College of Surgeons.The doctor is the Care Quality Commission registered manager. Circumcisions are carried out using both Forceps Guided and Plastibell (ring) methods under local anaesthetic. Children and babies are circumcised with both parents consent and present during the procedure.

The clinic opening hours are Monday to Friday 9-5pm and Saturdays 10-3pm.

The service is registered with the Care Quality Commission for the regulated activity of surgical procedures.

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 26 October 2021

This service is rated as Good overall. (Previous inspection 31 May 2019 – Good)

The key questions are rated as:

Are services safe? – Good

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 LMCS Limited. We inspected this service as part of our inspection programme. When the service was last inspected in May 2019 it was rated good overall, the effective domain was rated requires improvement as we issued a requirement notice for a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At the inspection on 6 July we found no significant concerns and no breaches of regulation were identified.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently. This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements. This included:

• Requesting evidence from the provider
• Short site visit on 6 July 2021

Our key findings were:

• When something went wrong, there was an appropriate, thorough review that involved all relevant staff. Lessons were learned and communicated to support improvement.
• Action had been taken since our May 2019 inspection to address the breach of regulation identified in the requirement notice issued for Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• There were effective systems in place for ensuring patient safety such as updated infection prevention and control protocols in line with guidance for the pandemic.
• Leadership, governance and practice management arrangements promoted the delivery of high-quality, person-centred care

Although no breaches of regulation were identified, there were areas where the provider should make improvements:

• All equipment to be used for medical emergencies should be maintained within the expirydate of the medicine concerned.
• All sharps bins should be removed before filling beyond the fill line.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care