Blackberry Orthopaedic Clinic-Guildford

We carried out an announced comprehensive inspection at Blackberry Orthopaedic Clinic - Guildford on 23 January 2020 as part of our inspection programme, under Section 60 of the Health and Social Care Act 2008. 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. This was the provider’s first inspection of the service since it registered with the Care Quality Commission (CQC).

Blackberry Orthopaedic Clinic - Guildford is an independent provider of specialised treatments of musculoskeletal conditions, including back pain and sports injuries, as well as pain management of chronic conditions. The service offers a range of specialist diagnostic services and treatments, which include health assessments and physiotherapy.

This service is registered with the Care Quality Commission (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 services and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Therefore, we were only able to inspect the health screening service as well as clinical consultations, examinations and treatments in general medicine for example; musculoskeletal and sports medicine. Services are also provided to patients under arrangements made by their employer or insurance provider with whom the servicer user holds an insurance policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, we were only able to inspect the services which are not arranged for patients by their employer or insurance provider.

Blackberry Orthopaedic Clinic - Guildford is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening procedures.

The centre manager 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.

We asked for CQC comment cards to be completed by patients in advance of the inspection. We received 14 completed comment cards, which were all positive about the standard of care received. Patients felt that the care and treatment they received was efficient and caring, with staff being polite, knowledgeable, respectful and helpful.

Our key findings were:

• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients received care and treatment which met their needs and were provided with clear information about their procedures, possible side effects and after care.
• There was an effective system in place for reporting and recording significant events.
• The service held a range of comprehensive policies and procedures which were in place to govern activity. However, there were instances where these were not always operating as intended. For example, some safety procedures were not always followed by staff in the use of x-ray equipment.
• Storage of information held by the provider to manage the service, particularly in relation to staff recruitment and personnel records, did not promote ease of access to that information for managers.
• Medicines management processes did not ensure that medicines were stored securely whilst the service was operating.
• There were infection prevention and control policies and procedures in place to reduce the risk and spread of infection. However, the provider was unable to demonstrate that they held appropriate records relating to staff immunisations, in line with their own policy.
• The service proactively sought feedback from staff and patients, which it acted on. Regular surveys were undertaken, and reports collated from the findings and action taken where required.
• There was a clear leadership structure within the service and the team worked together in a cohesive, supportive and open manner.
• The service had systems in place to promote the reporting of incidents.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Staff worked well together as a team and all felt supported to carry out their roles. There was a strong team ethos and culture of working together.
• The culture of the service encouraged candour, openness and honesty.

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

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

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

The areas where the provider should make improvements are:

• Ensure fire safety procedures include the monitoring of staff and visitors entering and leaving the premises.
• Review arrangements for the storage of staff recruitment and personnel records, to facilitate ease of access and monitoring of compliance with organisational requirements by local managers.
• Review processes for the appraisal of health advisors to include all aspects of their role.
• Ensure local managers’ understanding and awareness of performance and safety issues across all treatments and services.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care