London City Healthcare

This service is rated as Requires improvement overall.

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 London City Healthcare

as part of our inspection programme.

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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. London City Healthcare provides a range of which are not within CQC scope of registration including physiotherapy and occupational health. Therefore, we did not inspect or report on these services.

Magnus Kauders 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:

• Most risks were well managed. However clinical equipment had not been calibrated since it was purchased in 2019; though the provider arranged for calibration shortly after our inspection. The arrangements for verifying the identification of adults accompanying children were not clear. However, we were told that consultations with children were very rare and that children attending the service were mainly there for services outside of CQC regulation.
• There was a system in place for acting on safety alerts and significant events.
• Care was provided in line with current legislation and guidance.
• The service undertook reviews of care with the aim of improving the quality of patient care.
• Patient feedback indicated that they were satisfied with the care provided and the service was easy to access during the hours were appointments were offered.
• There was a system for acting on complaints although the service had not identified an external party that patients could escalate complaints to if they were unhappy with the service’s response.
• Governance arrangements were sufficient to ensure that patients received safe and effective care though further development of systems of oversight would likely be required if the service expanded.
• The service had a clear vision, staff felt supported and there was a positive and open working culture. Although formal annual appraisals had not taken place within the last 12 months, we saw evidence of conversations between management and staff related to performance and development.

The area where the provider must make improvement as they are in breach of regulation is:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Develop governance systems around risk management and clinical safety as the service develops.
• Undertake formal annual appraisals for all staff.
• Include details of external organisations that patients can raise complaints with should they be dissatisfied with the service’s response.
• Schedule calibration of clinical equipment in accordance with manufacturer guidance.
• Put in place systems to verify the identity of adults accompanying children.

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