Messina Clinic Limited

This service is rated as Good 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 Messina Clinic Limited on 11-12 July 2022. This was part of our inspection programme. We previously inspected this service on 7 February 2018 and 18 April 2018 using our previous methodology, where we did not apply ratings. As a result of our findings following the February 2018 inspection, we issued a warning notice for Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance). As a result of our April 2018 inspection we found the service had made improvements and had met the relevant legal requirements. We inspected the service again on 18 June 2019 and had rated the service as Good in all five of our key lines of enquiries (safe, effective, caring, responsive and well-led). The service had not been inspected since it changed location on 12 August 2020.

Messina Clinic Limited is an independent healthcare practice which provides general medicine services primarily to the Brazilian and Hispanic community with 90% of their patients from Brazilian and Hispanic backgrounds, though it also sees patients who do not fall under this demographic. All staff members speak English and Portuguese, with most speaking Spanish as well. The service is based in the City of London.

The 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 are Act 2008 (Regulated Activities) Regulation 2014. Messina Clinic Limited provides a range of non-surgical cosmetic interventions, for example sclerotherapy (non-surgical treatment of damaged veins), which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The lead doctor 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:

• The service did not have all the required emergency medicines during the inspection with no risk assessment for their omission. Although they had ordered the medicine immediately after the inspection and showed us evidence it had arrived the following day, this had only taken place after we had inspected them (see full details of the action we asked the provider to take in the Requirement Notice at the end of this report).
• The service had appropriate policies in place to deal with safeguarding incidents, significant events and possible disruption to the service.
• Environmental risk assessments had been completed in the clinic to keep patients safe. Risk assessments were overdue in the administrative office, which was leased in another building, although we saw evidence of communication from the service to have these risk assessments carried out.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We found a breach of regulation. The provider must:

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

The areas where the provider should make improvements are:

• Ensure environmental risk assessments are carried out in their administrative office.

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