22 February 2018
During a routine inspection
We carried out an announced comprehensive inspection on 22 February 2018 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 that this service was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this service was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this service was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this service was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this service was providing well-led care in accordance with the relevant regulations.
We carried out this inspection 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 service provides treatment for men experiencing Testosterone Deficiency Syndrome, erectile dysfunction and prostate health concerns.
The service made use of patient feedback as a measure to improve services. They had produced their own survey form and results were analysed on an annual basis. Results obtained from a survey review in November 2016 found that 100% of eligible patients said they were able to make an informed decision about the treatment they might receive.
We also received 41 Care Quality Commission comment cards from users of the service. These were very positive regarding the care delivered and mentioned the friendly and caring attitude of staff. Responses stated that the service was professional, thorough and easy to access. People also told us they found the premises hygienic and that they were treated with dignity.
Our key findings were:
- The service was offered on a private, fee paying basis only and was accessible to people who chose to use it.
- Assessment and referral processes were safely managed and there were effective levels of patient support and aftercare.
- The service had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
- There were systems, processes and practices in place to safeguard patients from abuse, and staff were able to access relevant training to keep patients safe.
- Information for service users was comprehensive and accessible.
- Patient outcomes were evaluated, analysed and reviewed as part of quality improvement processes and clinical audit.
- We saw evidence that when a complaint was received it was investigated thoroughly and mechanisms were in place to make subsequent improvements to the service based on complaints.
- There was a clear leadership structure, with governance frameworks which supported the delivery of quality care.
- The service encouraged and valued feedback from service users. Comments and feedback for the clinic showed high satisfaction rates.
- Communication between staff was effective with and there was a positive and open culture.
There were areas where the provider could make improvements and they should:
- Review how clinical treatment pathways could be formally agreed and documented across the clinical team.
- Review the implementation plan associated with their most recent clinical audit and consider an ongoing programme of audit activity.