• Hospital
  • Independent hospital

The London Heart Centre Ltd

Overall: Good read more about inspection ratings

22 Upper Wimpole Street, London, W1G 6NB (020) 7034 4030

Provided and run by:
The London Heart Centre Ltd

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The London Heart Centre Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about The London Heart Centre Ltd, you can give feedback on this service.

12 June 2019

During an inspection looking at part of the service

The London Heart Centre Ltd is operated by The London Heart Centre Ltd. The centre opened in 1978 and has been managed by The London Heart Centre Ltd since 2007. The service offers diagnostic tests for adults aged over 18 years.

Patients are offered electrocardiogram (ECG), stress echocardiography (stress echo), 24-hour blood pressure monitoring, Holter monitor, 14-day heart monitoring, exercise test, transthoracic echocardiogram and contrast echocardiogram services.

The service had two diagnostic imaging rooms in the basement and a consultation room on the ground floor.

We last carried out an announced focused comprehensive inspection of the service in November 2018. The service was rated inadequate for safe and well-led and good for caring and responsive. The service was judged to be inadequate overall and placed under special measures.

We re-inspected this service using our focused comprehensive inspection methodology. Our inspection was announced (staff knew we were coming) to ensure that everyone we needed to talk to was available. We spoke with two patients and five members of staff, including consultants, a cardiac physiologist, senior managers and a receptionist. We observed two episodes of care and treatment and reviewed six care records. We reviewed a range of equipment including emergency equipment and diagnostic devices. We also reviewed the service performance data.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this service improved. We rated it as Good because.

  • Our rating of the service had improved. We rated it as good because the service had taken note of concerns raised about the service at the previous inspection and made improvements in the areas of mandatory training, effective leadership, policies, audits, appraisals, oversight on the risk register, risk assessments, recruitment process leadership, engagement and governance. However, further improvement was identified in the management of incidents, duty of candour, governance process and engagement with the public and stakeholders.

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The majority of staff received up-to-date mandatory training. The overall compliance for all staff was 87% which was better than the providers own target (80%).

  • The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.

  • Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.

  • The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

  • The service used systems and processes to safely prescribe, record and store medicines.

  • The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance.

  • Doctors and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.

  • Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients.

  • Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

  • People could access the service when they needed it. Waiting times from referral to the diagnostic tests were in line with good practice.

  • Leaders had the integrity, skills and abilities to run the service. They were visible and approachable in the service for patients and staff.

  • The service had a vision for what it wanted to achieve and a strategy to turn it into action. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy.

  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work, and provided opportunities for career development.

  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.

  • Leaders and staff actively and openly engaged with patients and staff to plan and manage the service.

  • At the last inspection, there was lack of oversight on quality and effectiveness of the services, clinical policies, audits, managing of information and staff recruitment process. During this inspection, we found improvement and the service had addressed the issues and now had processes in place to continually improve the quality of service provided to patients.

However:

  • Although staff knew what incidents to report and how to report them, the managers did not investigate incidents thoroughly. Some staff we spoke to did not understand the legal duty of candour.

  • Although the service provided mandatory training in key skills to all staff, there was no robust system in place to ensure everyone had completed it. The service did not have a ratified mandatory training policy in place for staff.

  • Although there was improvement in the governance process and the current governance structure had recently been initiated, the governance structures were not yet sufficiently embedded to give assurance that it would provide a robust framework of governance.

  • Although the service now had up to date policies in line with national guidance, some policies were not yet in place in the service such as did not attend (DNA) appointment and turnaround time of diagnostic tests.

  • The service did not have access to an interpreter for patients whose first language was not English.

  • Although the service had improved on managing complaints and had complaints leaflets accessible in the waiting room, there were no posters prompting patients on how to make a complaint or raise concerns.

Nigel Acheson

Deputy Chief inspector of Hospitals (London and the South East)

06 November 2018

During an inspection looking at part of the service

The London Heart Centre Ltd is operated by The London Heart Centre Ltd. The centre opened in 1978 and has been managed by The London Heart Centre Ltd since 2007. The service offers diagnostic tests for adults and young people.

Patients are offered electrocardiogram (ECG) and stress echocardiography (stress echo) services. The service had two diagnostic imaging rooms in the basement and a consultation room on the ground floor.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 06 November 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

We rated it as inadequate overall.

  • The service did not have an effective leadership structure including staff with the right skills and abilities to provide high-quality sustainable care.
  • The service did not have an effective system to improve service quality and safeguarded high standards of care by creating an environment for excellent clinical care to flourish.
  • Policies and procedures were not reviewed regularly and updated where required.
  • There were no clear lines of accountability and responsibility for completing the action plans from the governance audit, and Legionella and fire risk assessments.
  • There was no identifiable escalation policy for urgent findings or deteriorating patients.
  • The service did not comply with its recruitment policy to ensure all checks were completed prior to employment.
  • The service did not have a risk management strategy, setting out a system for continuous risk management.
  • The service did not actively engage with patients, staff, the public and local organisations to plan and manage appropriate services.
  • The service did not show commitment to improving services by learning from when things went well or wrong, promoting training and innovation.
  • The service did not provide adequate mandatory training in key skills to all staff. The service did not have a mandatory training policy or document that set out what skills were required to perform individual tasks.
  • Staff did not have adequate training on how to recognise and report abuse. Not all staff members understood how to protect patients from abuse, the relevant organisations to report to and their contact details.
  • The service was not registered to receive safety alerts
  • No health and safety risk assessment of the premises had been undertaken.

However, we also found the following areas of good practice:

  • The service controlled infection risk well. Staff kept equipment and the premises clean and adhered to infection control and prevention methods.
  • The service had suitable premises and equipment and maintained them well.
  • The service provided care and treatment based on national guidance. Managers checked to make sure staff followed guidance.
  • Staff of different grades worked together as a team to benefit patients. Doctors and other healthcare professionals supported each other to provide good care.
  • Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
  • The centre had a strong, visible person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices that affected London Heart Centre Limited. Details are at the end of the report.

‘I am placing the service into special measures.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.’

Nigel Acheson

Deputy Chief inspector of Hospitals (London and the South East)

11 December 2013

During a routine inspection

There was no opportunity to speak with people coming for tests on the day of the visit. However, we saw evidence that people were asked about their experiences of the service.

Prior to undergoing tests, the cardiologist sought information about a person's medical history, medications and allergies and gave people full explanations about the tests. The cardiologists had systems in place to monitor the quality of test results and benchmarked them to assess their accuracy.

On the day of the inspection the centre was clean and tidy. Personal protective equipment was available and staff cleaned clinical areas in between people's appointments.

Staff were suitably qualified and received appropriate training to enable them to provide the care that people needed.

Complaints and incidents were recorded and investigated and there was evidence that learning took place from these and changes were made to the service as appropriate.