We carried out an announced comprehensive inspection at Luton Circumcision Clinic on 18 October 2018. We found that this service was not providing safe care in accordance with the relevant regulations. The full comprehensive report on the October 2018 inspection can be found by selecting the ‘all reports’ link for Luton Circumcision Clinic on our website at www.cqc.org.uk.

This inspection was an announced focused desk based inspection carried out on 10 January 2019 to confirm that the practice had made the recommended improvements that we identified in our previous inspection on 18 October 2018. This report covers our findings in relation to those improvements made since our last inspection.

Our findings were:

Are services safe?

We found that this service was providing safe 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 Luton Circumcision Clinic is an independent health service based in Luton where circumcisions on children up to and including the age of 18 years are carried out.

Our key findings were:

• Risks to patient and staff safety had been assessed, in particular those relating to infection control and health and safety.
• Required actions identified following risk assessment had been completed.
• A system for monitoring staff immunity status had been developed in line with Public Health England guidance.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection on 18 October 2018 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. However the impact of our concerns is minor for patients using the service, in terms of quality and safety of clinical care. The likelihood of this occurring in the future is low once it has been put right. We have asked the provider to take action.

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 Luton Circumcision Clinic is an independent health service based in Luton where circumcisions on children up to and including the age of 18 years are carried out.

Our key findings were:

• There was a system in place for reporting and recording significant events.
• There was insufficient evidence to demonstrate risks to patient safety had been assessed, in particular those relating to infection control and health and safety.
• The doctor had adopted policies and procedures to govern activity. Although not all of these had been formally documented, we were advised by the doctor that he was in the process of expanding the formal documentation of policies and processes, in light of the expansion of the service.
• The doctor assessed patients’ needs and delivered care appropriately.
• There was an effective system for seeking consent.
• There was a system to update external bodies such as GPs where necessary of care and treatment being provided.
• Information about services and how to complain was available and easy to understand.
• The service proactively sought feedback patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvements are:

• Monitor recently established systems for undertaking risk assessments including completion of any identified actions for improvement.
• Follow up on any actions identified in the Legionella risk assessment.
• Develop a system for monitoring staff immunity status for particular viruses in line with Public Health England guidance.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice