Messina Clinic Limited

Updated 5 August 2022

Messina Clinic Limited is an independent provider of medical services primarily to the Brazilian and Hispanic community from its location at 8-9 Lovat Lane, London EC3R 8DW. The service also has an administrative office a two-minute walk from the clinic’s location at 43-45 Eastcheap, London EC3M 1AE. We visited both locations as part of the inspection.

Messina Clinic Limited had seen a growth in patient demand and had therefore recruited more clinical and non-clinical staff. They had moved into a larger location in August 2020 to accommodate the higher volume of staff and patients. The service had continued to grow and therefore moved their administrative office into a separate building in November 2021 and converted their previous administrative office into a consultation room.

The service provides general practice and cosmetic treatments which are available to any fee-paying patient. The service sees both children and adults. There are approximately 12,000 patients currently registered within the service. The service sees approximately 500 patients per month. Some patients are registered with an NHS GP.

The service consists of seven doctors, one nurse, one healthcare assistant, one service manager, a Human Resources consultant and administrative/receptionist staff.

The service is open from 9am until 6pm on Mondays to Fridays and 9am to 1pm on Saturdays. All services are provided at the Lovat Lane clinic and telephone and online consultations are also available.

The service is located on the lower ground floor of a leased building which is wheelchair accessible by lift. Monument Station is located less than 200 metres away from the clinic.

The service website address is:

http://www.messinaclinic.co.uk/en/index.php. The full website is available in English, Portuguese and Spanish.

How we inspected this service

We gathered and reviewed pre-inspection information before inspecting the service. We spoke with the registered manager, a nurse and members of the administrative team remotely the day before the inspection. On the day of the inspection, we reviewed patient records and spoke with a doctor. We reviewed a wide range of documentary evidence including patient records, policies, written protocols and guidelines, recruitment, induction and training records, significant event analyses and patient feedback. We had also carried out infection prevention and control checks, medication checks and premises and equipment checks on the day of the inspection.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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 5 August 2022

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Messina Clinic Limited on 11-12 July 2022. This was part of our inspection programme. We previously inspected this service on 7 February 2018 and 18 April 2018 using our previous methodology, where we did not apply ratings. As a result of our findings following the February 2018 inspection, we issued a warning notice for Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance). As a result of our April 2018 inspection we found the service had made improvements and had met the relevant legal requirements. We inspected the service again on 18 June 2019 and had rated the service as Good in all five of our key lines of enquiries (safe, effective, caring, responsive and well-led). The service had not been inspected since it changed location on 12 August 2020.

Messina Clinic Limited is an independent healthcare practice which provides general medicine services primarily to the Brazilian and Hispanic community with 90% of their patients from Brazilian and Hispanic backgrounds, though it also sees patients who do not fall under this demographic. All staff members speak English and Portuguese, with most speaking Spanish as well. The service is based in the City of London.

The service is registered with 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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of the Health and Social are Act 2008 (Regulated Activities) Regulation 2014. Messina Clinic Limited provides a range of non-surgical cosmetic interventions, for example sclerotherapy (non-surgical treatment of damaged veins), which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The lead doctor 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.

Our key findings were:

• The service did not have all the required emergency medicines during the inspection with no risk assessment for their omission. Although they had ordered the medicine immediately after the inspection and showed us evidence it had arrived the following day, this had only taken place after we had inspected them (see full details of the action we asked the provider to take in the Requirement Notice at the end of this report).
• The service had appropriate policies in place to deal with safeguarding incidents, significant events and possible disruption to the service.
• Environmental risk assessments had been completed in the clinic to keep patients safe. Risk assessments were overdue in the administrative office, which was leased in another building, although we saw evidence of communication from the service to have these risk assessments carried out.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We found a breach of regulation. The provider must:

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

The areas where the provider should make improvements are:

• Ensure environmental risk assessments are carried out in their administrative office.

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