Surrey Cardiovascular Limited - Huxley Road

Updated 14 September 2016

The inspection was carried out on 1 March 2016. Our inspection team was led by a CQC Lead Inspector. The team included a cardiologist specialist advisor, a CQC inspection manager and three CQC inspectors.

Prior to the inspection we had asked for information from the provider regarding the service they provided. We informed other organisations, for example Healthwatch, we were inspecting the service. However we did not receive any information of concern from them.

During our visit we:

• Spoke with a range of staff including the registered manager, clinical staff, administration and reception staff.
• Reviewed the personal care and treatment records of patients.
• Reviewed comment cards where patients and members of the public shared their views and experiences of the services.

To get to the heart of patients’ experiences of care and treatment, we always ask the following fives 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 14 September 2016

We carried out an announced comprehensive inspection on 1 March 2016 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this service was providing well-led care in accordance with the relevant regulations.

Background

The Surrey Cardiovascular Clinic (SCVC) is an independent clinic specialising in cardiology services related to the early diagnosis, investigation and treatment of patients with all forms of heart disease. It is a private outpatient clinic which provides advice for a range of problems, including chest pain, heart failure, high blood pressure and breathlessness. Patients can undergo a range of cardiovascular tests including stress testing and electrocardiograms. The service is consultant led and supported by a team of nurses and technicians.

The lead consultant is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

The clinic is located in self-contained premises close to the Royal Surrey County Hospital. It has free parking and the buildings are accessible to disabled patients. Its facilities included three consulting rooms, four investigation/procedure rooms, reception and waiting area. Administration staff were based in a building nearby. The clinic had a service level agreement with a pathology laboratory.

The clinic was open Monday to Friday 8am to 5pm. Tuesday and Thursday’s appointments were available until 8pm. There was no out of hour’s provision or agreement with external stakeholders.

As part of our inspection, we asked for CQC comment cards to be completed by patients prior to our inspection. We received 55 comment cards, which were all positive about the standard of care received. Patients reported they had received an excellent service and staff were caring and helpful.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording incidents.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The clinic had good facilities and was well equipped to treat patients and meet their needs.
• There were systems in place to check all equipment had been serviced regularly.
• Risks to patients were well managed. There were effective systems in place to reduce the risk and spread of infection.
• Staff were up to date with current guidelines and were led by a proactive management team.
• Staff assessed patient’s needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Staff were kind, caring, competent and put patients at ease.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management. The clinic proactively sought and acted on feedback from staff and patients.
• The provider was aware of and complied with the requirements of Duty of Candour.
• All staff had received training in the Mental Capacity Act 2005 and obtained consent prior to treatment. However, we found on one occasion this was not always done in line with legislation and national guidance but was done in the patients best interest.

We identified regulations that were not being met and the providermust:

• All staff must receive training in safeguarding children to a level that is appropriate for their role in line with nationally recognised guidance.
• Staff must have appropriate training in gaining consent from children which is relevant to the child’s age and capacity to consent, including knowledge and understanding of ‘Gillick competence’.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements andshould:

• The registered provider should ensure they assess, monitor and improve the quality of service by strengthening the programme of clinical audits to ensure these are completed with timelines for improvement and review are identified and implemented.
• The provider should ensure that all patients who have capacity understand and consent to their treatment, regardless of any physical illness which reduces their ability to verbalise their consent.