Archived: French Medical Clinic

Updated 2 July 2018

The provider 21st Century Clinic Limited has two locations registered with the Care Quality Commission. The French Medical Clinic is located in the basement of Harley House, Brunswick Place in London and provides general medical services to any fee paying patient; however the service is predominantly aimed at French speaking patients from Britain and overseas. The service has a high number of patients from French speaking African nations, as well as Somalia, and British patients from Somali communities across England.

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.

Professor Boyde 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.

The service includes the full range of non-emergency services you would expect from a private GP service, and is available by appointment or on a ‘walk in’ basis.

The service offers appointments with the GP with referral to specialist services as required. The practice is open from Monday to Friday from 8am to 6pm.

The practice treats adults and children. Patients can book appointments by telephone or in person. It has a registered patient list receiving primary care as required and also provides services on an ad hoc basis, for example to tourists. The practice estimates that it currently has around 1600 registered patients actively using its services.

Patient facilities are provided in a basement room of rented premises in Brunswick Place, however there is no lift. The staff team include three GPs - two males and one female, a practice manager, part-time nurse and two reception staff.

We carried out this inspection on 10 April 2018. The inspection team comprised a lead CQC inspector, GP specialist advisor and a second inspector.

The Care Quality Commission had previously inspected French Medical Clinic on 22 July 2013, 19 August 2014, 27 February 2015 and 13 June 2017. Following these inspections, reports were issued identifying failures to comply with Regulations current at the time of inspection

Before this inspection visit, we reviewed a range of information we hold about the service and asked the practice to send us some information about the service which we also reviewed.

During our visit we:

• Spoke with the lead GP, the practice manager and a receptionist.

• Reviewed comment cards where patients had shared their views and experiences of the service in the days running up to the inspection.

• Reviewed documentary evidence relating to the service and inspected the facilities, equipment and security arrangements.

• We reviewed a number of patient records alongside the GP. We needed to do this to understand how the service assessed and documented patients’ needs, consent and any treatment required.

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 formed the framework for the areas we looked at during the inspection.

Updated 2 July 2018

We carried out an announced comprehensive inspection on 10 April 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 not 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 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. 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 Care Quality Commission previously inspected French Medical Clinic on 22 July 2013, 19 August 2014, 27 February 2015 and 13 June 2017, under our previous methodology. Following these inspections, reports were issued identifying failures to comply with regulations current at the time of inspection.

Seventeen patients provided feedback about the service. All the comments we received were positive about the service, for example describing the doctors as caring.

Our key findings were:

• The GP could not demonstrate they were delivering effective care and treatment based on evidence based guidelines.

• All staff had not undertaken safeguarding training to appropriate levels, including the safeguarding lead for the service.

• Staff carrying out the role of chaperone had not been trained to do this effectively.

• The provider did not have effective systems in place to record, monitor and analyse significant events.

• Equipment in the premises had not been serviced or checked by a person experienced to do so, to ensure it was suitable for the purpose for which it was being used.

• The practice did not have any protocols for prescribing and repeat prescribing and there was no system in place to link prescriptions issued to patients with their care records.

• The service did not have any systems in place for knowing about and taking action on notifiable safety incidents.

• The service did not have a quality improvement programme in place to monitor the quality of care and treatment.

• Staff who carried out the ultra sound scanning and gynaecological examinations did not have the qualifications, training, skills and experience to do so safely.

• There was no system in place for following up referrals or pathology results.

• CQC comment cards indicated patients were treated with compassion, dignity and respect.

• Fees were clearly set out and cost saving initiatives available.

• The practice did not have a business continuity plan.

• Staff did not receive formal appraisals or development reviews and were not supported to perform their duties competently through identifying required training.

• The provider did not maintain accurate, complete and contemporaneous records in respect of each patient.

• Information about how to complain was available. The provider had not received any complaints about the service in the last year.

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

• Ensure care and treatment is provided in a safe way to patients.
• Ensure persons providing care and treatment have the qualifications, competence, skills and experience to do so safely.
• Ensure equipment used for the care and treatment of service users is properly maintained, serviced and calibrated.
• Establish and operate effective systems or processes to assess, monitor and improve the quality and safety of service users.

Such were the failures to meet regulations we have taken action in line with our enforcement procedures to urgently vary the conditions of the providers registration preventing them from operating the service at this location. The provider has not appealed this decision.