We carried out an announced comprehensive inspection at Harley Street Healthcare Clinic on 21 February 2018 to ask 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 provider, Harley Street Healthcare Clinic Limited, is registered with the CQC as an organisation providing private consultations, diagnosis and treatment by a GMC registered doctor from consulting rooms at 104 Harley Street, London W1G 7JD. The location is registered to provide the regulated activities of treatment of disease, disorder or injury and diagnostic and screening procedures.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical practitioner. At Harley Street Healthcare Clinic the aesthetic cosmetic treatments provided are exempt by law from CQC regulation. Therefore we did not inspect these services as part of this inspection.

The provider is the Medical Director and Registered Manager for the service. 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.

At this inspection we found:

• The practice had systems to manage risk and provide safe care and treatment.
• An annual service of the medical refrigerator and thermometer calibration was not undertaken to ensure this was functioning appropriately and there was no Cold Chain Policy in place to ensure the safe management of medicines stored in the fridge. Daily minimum and maximum temperatures were not recorded. The provider submitted evidence that immediately following the inspection they put in place a cold chain policy and had commenced written records.

• The premises were clean and tidy. The provider had undertaken a recent infection prevention and control (IPC) audit. However, there was no IPC lead with appropriate training identified within the service. Following the inspection the provider submitted evidence that the doctor successfully undertook appropriate training.
• The provider routinely reviewed the effectiveness and appropriateness of the service provided to ensure it was in line with current guidelines. They informed us that they had arrangements in place to receive and comply with patient safety alerts. However, there was no formal record kept of actions taken and learning shared with staff.
• A Patient Guide was given to all patients when registering which included details of the service provided. Clear information regarding the cost of services was given on the website.
• The patient survey results showed that patients were satisfied with the care they received.
• The facilities and premises were appropriate for the services delivered.
• The provider had the experience, capacity and skills to deliver a quality, sustainable service and to address any risks. There was a strong focus on continuous learning, improvement and development of services and staff. Staff had received an annual appraisal.

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

• Review their procedures for the recording of action taken as a result of patient safety alerts to include a formal record of actions taken and learning shared with staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

People we obtained feedback from following the inspection said they were satisfied with the care and treatment they had received at the clinic. They confirmed they knew about the costs in advance of their treatment and said that their care and treatment options were explained well during their consultation. They also said they felt listened to and respected by staff.

Staff received appropriate professional development in the form of appraisals, training and peer support.

The clinic had provisions in place to assess and monitor the quality of service it was providing through regularly obtaining people’s feedback and reviewing their medical record keeping and improvements had been made as a result. In addition there was a complaints and incidents process in place. However none had been reported at the date of the inspection.