134 Harley Street

134 Harley Street is operated by Harley Street Fertility Clinic. The service has no overnight beds. Facilities include one operating theatre, outpatient and diagnostic facilities. The service provides surgical procedures.

We inspected surgery.

We inspected this service using our comprehensive inspection methodology.

We carried out an unannounced inspection on 2 October 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this hospital/service stayed the same. We rated it as Good overall because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and gave them access to good information. Key services were available six days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to continuously improving services.

However, we also found the following issues that the service provider needs to improve:

• The safeguarding policy did not reflect most recent national best practice guidance. This was action we had previously told the provider to take on our last inspection.
• The service could not be assured that staff always controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection, but these were not always consistently used or reliable. Not all staff at the service were bare below the elbow, and leaders had not completed the action plan from the most recent infection prevention and control audit.
• We found one instance where the disposal of a controlled drug was not recorded correctly.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (South & London)