We carried out an announced comprehensive inspection of Chelsea Bridge Clinic on 2 November 2017 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.

Background

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.

Aspen Medical Services Ltd provides private medical services from purpose built premises at Chelsea Bridge Clinic, Ground Floor Riverfront, Howard Building, London, SW8 4NN. The clinic provides whole health and well-being solutions offering services including physiotherapy, hyperbaric oxygen therapy, dermatology, cosmetic services, weight loss services including nutritional therapy and personal training programmes, acupuncture, coaching, laser aesthetics and blood collection.

The premises consist of a ground floor, level access patient reception and waiting area, second patient waiting room, fitness studio, consultation rooms, treatment room and hyperbaric oxygen therapy room. There are also storage and maintenance areas and staff offices on the ground floor. A mezzanine level provides space for a third patient waiting area, shower room and treatment rooms for the wellbeing services offered.

Clinic services are available to any fee paying patient and is primarily focussed on services for adults.

The service has one director and one clinic manager. The clinic staff include physiotherapists, personal trainers, men’s health specialist, nutritionist, consultant dermatologist, hyperbaric oxygen therapist, a registered nurse, nurse assistant and reception hosting and administrative assistants. Those staff who are required to register with a professional body were registered with a licence to practice. Relevant staff were also registered for providing specialist services. The clinic outsourced its human resources, accounting, information technology, telephony and legal services, with the clinic manager responsible for monitoring contracts.

The service operates Monday to Saturday and on Sunday by request. Clinic hours run from 11am to 8pm on a Monday, 8.30am to 9pm Tuesday to Friday and 8.30am to 5.30pm on a Saturday. The clinic does not offer out of hours services but does offer patients enquiring about out of hours care contact details for a separate provider for this service.

Since 2008 the clinic has provided services for 16,700 patients across all of its services. The dermatology service is operated by a consultant dermatologist providing one clinic per month with an average of three to seven patients. The majority of appointments are consultation with very few minor surgery procedures being carried out at the clinic. Hyperbaric oxygen therapy appointments are available three to four days a week with an average of six to eight patients per clinic. Hyperbaric oxygen therapy is provided at a level considered as complimentary treatment to alleviate a range of symptoms and support recovery and wellbeing and is not a cure or treatment for specific medical conditions. Complex medical cases are referred to specialist hyperbaric oxygen therapy services.

The clinic 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. The clinic is registered with the Care Quality Commission (CQC) to provide the regulated activities diagnostic and screening procedures, surgical procedures and treatment of disease, disorder or injury,

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. We received 31 comment cards which were all extremely positive about the standard of care received, across all of the services offered. Comments included that staff, were kind, caring, welcoming, helpful and treated patients with respect. Comments about the service included that the clinic was clean and hygienic, that patients felt listened to, they were given a thorough explanation of treatment options and that the treatment they received was effective. We also spoke with two patients during the inspection who said they were very satisfied with the care they received and told us that appointments ran on time but that they were not rushed, that they were involved in their care and treatment and that the clinic provided an excellent level of service to their whole family.

Our key findings were:

• The clinic had a clear vision, embedded in the service culture, to deliver high quality care for patients.
• There was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice.
• The service had clearly defined and embedded systems, processes and practices to minimise risks to patient safety.
• The service had adequate arrangements to respond to emergencies and major incidents.
• Staff were aware of and used current evidence based guidance relevant to their area of expertise to provide effective care.
• Staff had the skills and knowledge to deliver effective care and treatment.
• Staff sought and recorded patients’ consent to care and treatment in line with legislation and guidance.
• Information we reviewed showed that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• Patient dignity, privacy and respect was highly valued.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The clinic proactively sought feedback from staff and patients and we saw examples where feedback had been acted on.

There were areas where the provider could make improvements and should:

• Review how safety alerts are received, reviewed and actioned where appropriate.
• Review the requirement for business continuity arrangements to be available in a single business continuity plan.
• Review how access to services and information may be improved for patients with disabilities.