We carried out an announced focused follow-up inspection on 15 January 2019 to ask the service the following key questions; Are services safe, effective, 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 well-led?

We found that this service was not 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. CQC inspected the service on 4 September 2018 and asked the provider to make improvements regarding medical record-keeping, audit and policies and procedures. We checked these areas during this follow-up inspection and found this had mostly been resolved. This report only covers our findings in relation to those areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Bodyline Clinic Limited Openshaw on our website at www.cqc.org.uk.

Our key findings were:

• Improvements had been made in medical record-keeping and prescribing was in line with the provider’s policy
• Medical history and paper records were now available when patients transferred from another bodyline clinic
• Audits of medical record-keeping had been improved and actions taken in response to identified issues were effective in driving improvement

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

• Continue to make improvements to the clinical audit process to demonstrate the safety and effectiveness of the treatments prescribed.
• Continue to improve the system in place to review and update policies and procedures

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 4 September 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. There were reliable safety systems and processes in place and risks to patients were well managed. However, clinicians did not always follow prescribing policies and record the rationale for prescribing decisions.

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations. There was no audit system in place to monitor the effectiveness of the treatments provided and patients did not always have an effective initial assessment to establish their needs. Clinicians and staff had the necessary skills, training and support to undertake their role.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations. Patients were treated with kindness and respect, and were routinely involved in decisions about their care and treatment. Patients told us their privacy and dignity needs were met at the clinic.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations. The facilities were appropriate to meet people’s needs. The provider routinely sought patient feedback, and carried out an analysis of patient needs when planning and delivering services. There was a procedure in place for handling concerns and complaints.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations. There was adequate leadership capacity and capability. A comprehensive set of policies and procedures governed all activities at the clinic, although some policy review dates had not been updated. Where audits found shortfalls in care or treatment, these had not been repeated to give assurance that improvement measures had been effective.

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.

Bodyline Openshaw is a private clinic which provides medical treatment for weight loss, and has been registered with CQC since January 2018. The clinic is open on Tuesdays from 4:30pm until 7:30pm, and Saturdays from 9:30am until 12:30pm. The premises comprise of a reception and waiting area, and consulting rooms situated on the ground floor. There is a clinic manager and five nurses who carry out patient consultations. One of the nurses 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 and associated Regulations about how the service is run.

Nine people completed CQC comment cards prior to our inspection, and these were all positive. Patients told us staff were friendly and helpful and treated them with respect, and the facilities were clean and comfortable.

Our key findings were:

• The facilities were appropriate to meet people’s needs
• Staff were caring, supportive, and treated patients with dignity and respect
• Clinicians did not always follow prescribing policies and record the rationale for prescribing decisions
• There were arrangements in place to audit medical records, however the actions taken in response to identified issues were not always effective
• There were a comprehensive set of policies and procedures governing all activities, although some policy review dates had not been updated

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

• Ensure systems and processes are established to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users

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

• Review the clinical records and filing system to ensure clinicians have access to all relevant information when consulting with patients
• Review policies and procedures to ensure review dates are appropriate