We spoke with staff and reviewed a range of records maintained by the provider. There were no people using the service who we could to speak to on the day of our visit. We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We also found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Appropriate checks were undertaken before staff began work. People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

We rated The Medical Foundation London as good because:

• Medical assessment rooms were equipped with the necessary equipment to carry out basic physical examinations. All areas were visibly clean and furnishings well maintained. There were good fire safety systems in place. Patients were seen promptly when referred to the doctor. Staff were familiar with the provider’s incident reporting procedures and were debriefed following incidents.

• Staff completed comprehensive assessments in a timely manner. Care and treatment records were personalised, holistic and recovery orientated. This included good assessment of patient’s physical health needs. The service offered patients a wide range of psychological therapies recommended by The National Institute for Health and Care Excellence (NICE ) and support for employment, housing and benefits. There were good working relationships between the doctors and therapists. Doctors supported patients to make decisions and sought patient consent before conducting medical consultations.

• Staff treated patients with kindness, dignity and respect. Patients were invited to give feedback on the service they received.

• The service reviewed patients promptly at different stages of the referral pathway. Medical consultation rooms were sound-proofed and well-maintained. The service offered patients a variety of support and activity groups. The service had very good access to interpreters. Key patient information was provided in 13 different languages. Patients knew how to complain and information on how to complaint was available to them. The service handled complaints appropriately.

• Staff enjoyed working at the service and were committed to providing good quality care and support to survivors of torture. The provider’s governance arrangements included checks that ensured doctors were appropriately qualified and competent. The service had a risk register in place and senior management reviewed it regularly. The service demonstrated its commitment to quality improvement and innovation.

However:

• The service did not have adequate systems in place to safely assess and manage risk to patients and staff. Where patients had mental health issues, staff had not completed comprehensive risk assessments and these were not updated following recent incidents. Risk management plans did not include information, developed with patients, on what to do in a crisis. There were inadequate systems in place to monitor patient’s change in risk when they were waiting to be seen at intake panel or initial assessment.

• The service had not always notified the Care Quality Commission (CQC) of notifiable incidents.

• Not all staff had completed the appropriate mandatory training. The service did not have systems in place to monitor staff supervision and mandatory training rates.

• The service had not kept up to date cleaning records for the building and examination equipment. The service had not completed an environmental risk assessment for the outdoor communal space, including the garden.