We carried out a focused inspection on the 25 April 2018 to ask the service the following key question: Is the service safe?

Our findings were:

Is the service safe?

We found that this service was providing safe 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.

CQC previously inspected this service on the 25 April 2017 and asked the provider to make improvements regarding the safety of the service. We checked this as part of this focussed inspection and found that this had been resolved.

The London Slimming Centre is a slimming clinic located on Edgware Road in North West London. The clinic consists of a reception room and a consulting room on the first floor of 406 Edgware Road. It is very close to Edgware Road tube station, and local bus stops. Parking in the local area is limited and the building is not wheelchair accessible.

The clinic provided slimming advice and prescribed medicines to support weight reduction. It is a private service. It is open for walk in or booked appointments all day on Mondays, Tuesdays, Wednesdays (until 3pm), Thursdays, and Saturday mornings.

Our key findings were:

• The provider had taken steps to ensure that all medicines dispensed to patients were labelled appropriately and relevant patient information was provided.
• The provider should continue to review arrangements regarding the use of chaperones and any associated training that may be required.
• The registered manager had received training in the safeguarding of both adults and children.
• The provider now had an emergency risk assessment document. However, this had not been translated into a procedure for staff to follow in the event of an emergency.

We carried out an announced comprehensive inspection on 25 April 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 not providing safe care in accordance with the relevant regulations because safety systems and processes were not reliable, the management of medical emergencies required review, staff were not suitably trained, risks to health and safety required review, the maintenance of equipment required review, and medicines were not managed safely.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations. We found areas where improvements should be made relating to the information provided to patients on the use of off label and unlicensed medicines.

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. We found areas where improvements should be made relating to the lack of policies regarding patients with protected characteristics.

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.

The London Slimming Centre is a slimming clinic located on Edgware Road, in North West London. The clinic consists of a reception room and a consulting room on the first floor of 406 Edgware Road. It is very close to a tube station and local bus stops. Parking in the local area is limited and the building is not wheelchair accessible.

The clinic is staffed by a receptionist and four regular female GPs; however there is only ever one GP on shift at any one time. If for any reason, a shift is not filled by one of the regular GPs, a locum GP is brought in. In addition, there is a governance manager based at the Bournemouth head office who attends the clinic on an ad hoc basis (roughly once a month). This clinic is one of 26 clinics that is run by the same provider organisation.

The receptionist 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 Regulations about how the clinic is run.

The clinic provided slimming advice and prescribed medicines to support weight reduction. It was a private service. It was open for walk ins or booked appointments on Mondays, Tuesdays, Wednesdays, Thursdays, and Saturday mornings. Patients were welcome to walk in and be weighed any time the clinic was open, and did not necessarily need to see the GP to do so.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of weight reduction. At London Slimming Centre, the cosmetic injections that are also provided are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment for weight reduction but not the cosmetic services.

Patients completed CQC comment cards to tell us what they thought about the service. We received 42 completed cards and all were positive. We were told that the service was very good, and that staff were helpful, informative, pleasant, respectful, welcoming and maintained people’s dignity at all times.

Our key findings were:

• Individual patient records were written and managed in a way to keep patients safe.
• The clinic appropriately refused to provide medicines to patients who did not fit the inclusion criteria for treatment.
• The feedback from patients was always positive about the care they received, the helpfulness of staff and the cleanliness of the premises.

We identified regulations that were not being met and the provider must:

• Ensure that all medicines dispensed to patients are labelled appropriately and that any relevant patient information is provided.
• Ensure that the registered manager is trained in the safeguarding of adults and children.
• Ensure the provision of chaperone training to staff.

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

• Review risk assessments with regard to medical emergencies.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Review fire safety procedures to provide assurance that patients would be kept safe in an emergency.
• Review how the calibration of weighing scales is documented.
• Review the information provided in relation to the use of off label and unlicensed medicines to ensure it is easily understandable to patients using the service.
• Review policies and training regarding patients with protected characteristics.

People who use the service were given appropriate information regarding their care or treatment. They were provided with information on dietary advice, a product information sheet on the medication prescribed and the possible side effects.

People’s care and treatment reflected relevant research and guidance. For example staff followed the National Institute for Health and Clinical Excellence (NICE) guidance on obesity.

There were systems in place to reduce the risk and spread of infection. The clinic appeared clean and well maintained on the day of the inspection.

Staff received professional development. They received formal appraisals. The manager discussed their last appraisal with us.

There was a complaints lead in the clinic. The complaints policy was displayed in the reception area and visible to people using the service.

We did not speak to people who use the services on this occasion however we saw evidence that people were satisfied with the service provided by the London Slimming Centre