We carried out an announced comprehensive inspection on 8 August 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.

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 Functional Gut Clinic is an independent clinic in the central London, which offers advanced diagnostic and screening procedures in alimentary (relating to nutrition) and gastrointestinal (relating to the stomach and intestine) medicine related healthcare service.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the services it provides. They provider employs 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.

We spoke with two patients and received 16 patient Care Quality Commission comment cards. All of the comment cards we received were positive about the service. Patients said they were satisfied with the standard of care received and said the staff was approachable, committed and caring.

Our key findings were:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• Most risks were generally well managed though improvements were needed in relation to responding to emergency medical situations, business continuity planning, fire evacuation plan (in particular for patients with mobility problems) and the management of legionella.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Consent procedures were in place and these were in line with legal requirements.
• Systems were in place to protect personal information about patients.
• Appointments were available on a pre-bookable basis. The service provided only face to face consultations.
• The practice had excellent facilities and was well equipped to treat patients and meet their needs.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Staff had received up to date training relevant to their role. Staff appraisals had been completed in a timely manner.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Information about services and how to complain was available.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• There was a clear vision and strategy and staff spoke of an open and supportive culture.

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

• Ensure care and treatment is provided in a safe way to patients.

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

There were areas where the provider

should

make improvements:

• Review and act upon the staff feedback regarding staffing levels of non-clinical staff.
• Develop a formal documented business continuity plan.
• Carry out a Disabled Access Audit or Disability Discrimination Act (DDA) Audit.
• Provide information about a translation service and display in the waiting area.
• Improve access for patients with hearing difficulties.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice