We carried out an announced comprehensive inspection on 5 October 2017 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 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.

The Wharfedale Clinic is situated in Guiseley, Leeds LS20 8AR, located approximately nine miles north west of Leeds City Centre. The service provides treatment for musculoskeletal conditions and sports injuries. Treatment is provided for adults and children. It is housed in a two storey building. There are three clinical rooms, two downstairs and one on the first floor. Patients with mobility problems are able to be seen in one of the downstairs rooms. The ground floor of the building is accessible to patients with mobility problems or those who use a wheelchair. Limited parking is available on site, but on-street parking is available in adjacent streets. In addition, parking is available in an adjacent supermarket which enables patients to park there for up to three hours. The service is accessible by public transport. The Wharfedale Clinic provides treatment and/or diagnostic services for between 100 and 200 patients per month. Patients can access the service from anywhere in the local or wider area. Some patients travel from further afield, including from Scotland and the Continent.

Treatments are available from one medical practitioner (male), with expertise in musculoskeletal conditions, sports medicine and osteopathy. Additional clinical expertise is provided by two independent clinicians; one physiotherapist (female) who has expertise in sports injury and exercise management and one podiatrist (male) with expertise in biomechanics and sports injuries.

The service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, the services it provides. The service is registered for the provision of diagnosis, advice or treatment under the supervision of a medical practitioner, including the prescribing of medicines for pain associated with musculoskeletal conditions. The services provided by the physiotherapist and podiatrist at the clinic are not activities regulated by the CQC. Therefore these services did not fall under the scope of our inspection. We were only able to inspect the services provided by the medical practitioner at the service.

The clinical team is supported by a practice manager and two receptionists (all female).

Opening times are 9am to 5pm, Monday to Friday. The service is closed on alternate Wednesdays and Fridays.

The medical practitioner 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.

We spoke with one patient during the inspection. In addition we spoke with two people who had provided transport for patients receiving treatment at the service. They described the service as ‘fantastic’. Staff were cited as ‘friendly and welcoming’; the facilities were described as ‘first class’. We received 24 CQC comment cards which had been completed by patients accessing the service both before and during our visit. These too were all overwhelmingly very positive. Comments included: ‘staff have been very friendly and professional’; ‘the treatment was great and I got exactly what I needed’. Premises were described as ‘very clean and hygienic’.

Our key findings were:

• Medicines were safely managed.
• The service had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
• There were systems, processes and practices in place to safeguard patients from abuse.
• The staffing levels were appropriate for the care and treatment offered by the clinic with an appropriate staff skill mix across the service.
• The service had risk management processes in place to manage and prevent harm.
• There was an infection prevention and control policy; and procedures were in place to reduce the risk and spread of infection.
• Patient outcomes were evaluated and reviewed as part of quality improvement processes.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• Relevant information was shared with other services appropriately and in a timely way.
• The service was offered on a private, fee paying basis only and was accessible to people who chose to use it.
• Although no complaints had been received in the preceding year; there was a complaints policy, which described appropriate processes to respond to complaints; and mechanisms in place to share learning with relevant staff.
• There was a clear leadership structure, with governance frameworks which supported the delivery of quality care
• The service encouraged and valued feedback from patients and staff

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

• Review the provision of basic life support training for reception staff.
• Review the arrangements in place to carry out fire drills on a regular basis.
• Review their recruitment and induction processes for staff, including the retention of proof of identification, references and documented induction processes.