Archived: Samedaydoctor London City Clinic

We carried out an announced comprehensive inspection at Samedaydoctor London City Clinic under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Chief Medical Officer is the registered manager, although this is due to change in the near future. 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.

We received 18 completed CQC comment cards, all of which were positive and indicated that people were treated with kindness and respect. Comments included staff were caring, helpful and friendly; informative and supportive; and that the service efficient and accommodating.

Our key findings were:

• Patients received effective care and treatment that met their needs. The way in which care was delivered was reviewed to ensure it was delivered according to best practice guidance and staff were well supported to update their knowledge through training.
• Patients were offered appointments between 9am to 6pm, Monday to Friday, and 10am to 2pm on Saturday, at a time that was convenient to them.
• There were effective procedures in place for monitoring and managing risk to people and staff safety.
• There was a lack of a systemic approach for ensuring patient safety alerts had been actioned.
• The service could not demonstrate that they provided care in a way that kept patients safe and protected them from avoidable harm. For example: the safeguarding policies needed to be updated to reflect some of the new categories of abuse, the service needed to evidence that staff had received a Disclosure and Barring Service (DBS) check at an appropriate level to their role, and patient group directions needed to be current and up to date.
• Staff were supported with their personal development and received opportunities for supervision, training and mentoring appropriate to their work.
• There were clear responsibilities, roles and systems for accountability to support good governance and management. However, some of the arrangements were on an informal basis, so it was difficult for the service to evidence any action taken or feedback given.
• There was an overarching provider vision and strategy with evidence of good local leadership within the service.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure specified information is available regarding each staff employed.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Update the safeguarding policies to reflect all the new categories of abuse.
• Introduce a systematic approach to confirm that patient safety alerts are actioned.
• Provide written evidence that new staff have completed an induction.
• Formalise the system for sharing information with the local staff team.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Update PGDs in a timely manner to reflect the service’s own guidance and in line with NICE guidance.

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