Archived: Poland Medical

We carried out an announced inspection on 29 August 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check on concerns we had received and whether the registered provider was meeting the legal requirements within the Health and Social Care Act 2008 and associated regulations.

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the requirement notice section at the end of this report).

Are services effective?

We found that this service was providing not effective care in accordance with the relevant regulations (see full details of this action in the requirement notice section at the end of this report).

.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 not providing well-led care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the requirement notice section at the end of this report).

Background

Poland Medical is an independent provider of medical services and treats both adults and children in the London Borough of Ealing. Services are provided primarily to Polish people. Services are available to people on a pre-bookable appointment basis. The clinic employs doctors on a sessional basis most of whom are specialists providing a range of services from gynaecology to psychiatry. Medical consultations and diagnostic tests are provided by the clinic however no surgical procedures are carried out.

The clinic also provides dental services. A copy of the full report of the dental service is available on our website:

http://www.cqc.org.uk/search/services/doctors-dentists

The property is leased by the provider and consists of a patient waiting room & reception area, one dental surgery and three medical consultation rooms which are all located on the ground floor of the property.

Poland Medical is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, surgical procedures and treatment of disease, disorder or injury.

The clinic is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Poland Medical is the owner of the service.

The clinic employs 13 doctors all of whom are registered with the General Medical Council (GMC) with a licence to practice. The doctors work across both the West London and Coventry locations. Other staff include the registered manager and a team of reception staff. Poland medical is a designated body (an organisation that provides regular appraisals and support for revalidation of doctors) with one of the specialist doctors as a responsible officer (individuals within designated bodies who have overall responsibility for helping with revalidation). The doctor is also medical advisor to the clinic.

The clinic is open Monday to Friday from 8am to 8pm, Saturday from 8am to 5pm and Sunday from 11am to 6pm. The provider does not offer an out of hours service or emergency care. Patients who require emergency medical assistance or out of hours services are requested to contact NHS direct or attend the local accident and emergency department.

Our key findings were:

• Systems and processes were in place to keep patients safe. However, we identified some shortfalls in relation to safeguarding children, staff recruitment, infection control and the management of prescription pads.
• There was some evidence that staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Some quality improvement was evident however it was limited particularly in relation to clinical audit. There were no medicine audits carried out to monitor the effectiveness of prescribing.
• Information about the services and how to complain was available. Complaints were dealt with in a timely way.
• Governance arrangements were in place however there was no program of continuous clinical and internal audit and no structured meetings that allowed for the sharing of learning from complaints and significant events with all staff.
• There were no multi-disciplinary meetings.
• We did not see any evidence of clinical supervision.
• There was no system for the reconciliation of pathology test results.

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

• Ensure patients are protected from abuse and improper treatment.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Introduce formal supervision and support for clinical staff.

In addition the provider should:

• Review how prescription pads are managed.
• Develop the vision for the clinic and implement a strategy to deliver it.
• Update policies and procedures to include review dates.
• Review the system of managing communication with a patient’s NHS doctor.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out an announced inspection on 29 August 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check on concerns raised which we had received and whether the registered provider was meeting the legal requirements within the Health and Social Care Act 2008 and associated regulations. The inspection was led by two CQC inspectors who were supported by two specialist advisers.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Poland Medical is an independent provider of medical services and treats both adults and children in the London Borough of Ealing. Services are provided primarily to Polish patients. Services are available to people on a pre-bookable appointment basis. The clinic provides dental services and a variety of other additional services including gynaecology services.

The property is leased by the provider and consists of a patient waiting room & reception area, one dental surgery and three medical consultation rooms which are all located on the ground floor of the property.

Practice staffing providing dental services consists of two dentists, one dental nurse, one trainee dental nurse and two receptionists.

The practice is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Poland Medical was the owner of the service

During the inspection we spoke with the registered manager and two receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between Monday to Friday 8am to 8pm, Saturdays 8am to 5pm and Sundays 11am to 6pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• Governance systems required improvement to ensure audits were undertaken regularly and were used to drive improvements.
• The clinical staff provided patients’ care and treatment in line with current guidelines however improvements could be made consistency in the completion of dental care records and giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

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

• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography and infection prevention and control are undertaken at regular intervals to help improve the quality of service. Practice should also ensure, that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the radiograph, the reporting and quality of the radiograph giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.