We carried out a focussed inspection of Prime Health & Beauty Clinic – Derby on 20 April 2017. This was to check that improvements had been made following the breach of legal requirements we identified from our comprehensive inspection carried out on 24 February 2016. During our inspection in February 2016 we identified regulatory breaches in relation to regulations 13 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

This report only covers our findings in relation to the areas identified as requiring improvement following our inspection in February 2016. You can read the report from this comprehensive inspection, by selecting the 'all reports' link for SDC (UK)1 Limited Prime Health & Beauty Clinic - Derby on our website at www.cqc.org.uk. The areas identified as requiring improvement during our inspection in February 2016 were as follows:

• Ensure that the doctor undertakes training on safeguarding vulnerable adults
• Ensure that recruitment procedures are followed and that the relevant checks are made on clinical staff in line with Schedule 3 of the Health and Social Care Act (Regulated Activities) Regulations 2014

Our focused review on 20 April 2017 showed that improvements had been made

The registered manager of this service is a doctor and is registered and licensed to practice with the General Medical Council (GMC) and was the only member of staff who treated people visiting the service. For clarity within this report the registered manager is referred to as the doctor.

Six people that were using the service on the day of our visit told us that they had received information about the medication they were prescribed and confirmed that they had signed consent forms regarding this. These six people’s records were looked at and also confirmed this.

People told us that they were involved in decisions about their treatment plan. One person told us, “I had a very thorough consultation initially, which took a long time but the doctor is very thorough and discusses my health at each visit, this includes discussions about my diet, exercise and if I have had any side effects from the tablets.” Another person said, “I have a consultation each time and this includes a blood pressure check as well as weight.” Records seen showed that at each visit people’s blood pressure, weight, body mass index (BMI) was checked and that consultations took place regarding people’s general health.

Medicines were stored appropriately and records were maintained to provide a clear audit trail for controlled drugs.

People using the service, the staff employed and other health professionals were consulted regarding their views of the service.

At our visit in August 2012 people using the slimming clinic told us they were happy with the service they received and felt they were given enough information to make decisions about their treatment. At this visit people we spoke to also confirmed this.

People’s consultations were held in private and they confirmed their privacy was respected.

At our visit in August 2012 we identified that the service did not protect people against the risks associated with the unsafe use and management of medicines. At this visit we found the arrangements for recording and monitoring of medicines had improved to ensure they could be checked and monitored more carefully.

At our visit in August 2012 we identified that the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service. At this visit we found that systems were now in place to monitor the effectiveness of treatment and any adverse effects that people had to medication prescribed.

At our visit in August 2012 we identified that people were not protected from the risks of unsafe or inappropriate care and treatment because the records about the care, treatment and support of people who used the service were not clear or complete. At this visit we found that improvements had been made to record keeping regarding the medication prescribed and consultations held with people.

People told us that they were happy with the service they received from the slimming and diet clinic. They said that they were given enough information to make decisions about their treatment.

People told us their consultations were held in private and confirmed their privacy was respected.

People said that they understood how to make a complaint if they were unhappy with the services they received and were asked for their views on the service and the treatment they received.

We carried out an announced comprehensive inspection on 24 February 2016 to ask the service the following 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.

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 (Regulated Activities) Regulations 2015, and to look at the overall quality of the service, under the Care Act 2014

Prime Health and Beauty Clinic provides a private weight reduction service for adults and supplies medicines and dietary advice to the patients who use the service.   The clinic operates from a ground floor consulting room on Burton Road in Derby.   It is open from 11am to 8pm on Monday, Wednesday, Thursday and Friday.

The clinic is run by one doctor who 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.   There is a clinic in Nottingham run by the same provider.   

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 Prime Health & Beauty - Derby, the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment for weight reduction and not the aesthetic cosmetic services. 

We spoke with three people on the day of the inspection and received feedback from 68 people who completed comment cards before our visit.   People said the staff at the clinic were caring and supportive and that they were given helpful information and advice.   They said the doctor listened to them and treated them with respect.

Our key findings were:

• Overall the clinic provided an effective service
• Arrangements were in place to manage medicines in a way that kept people safe
• There was a treatment protocol which we saw was followed
• Feedback from patients was positive.   People told us that staff were caring, and that they were given information about their treatment

• The clinic had a number of policies and procedures in place to govern activity.

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

• Ensure that staff undertake training on safeguarding vulnerable adults appropriate to their role
• Ensure that recruitment procedures are followed and that the relevant checks are made on clinical staff in line with Schedule 3 of the Health and Social Care Act (Regulated Activities) Regulations 2014

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should

• Ensure a system is in place for regular and appropriate cleaning, inspection, calibration, maintenance and replacement of equipment
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available
• Review their arrangements for dealing with medical emergencies
• Consider how to make the service accessible to patients who don't speak English