Updated 11 October 2019
LiveSmart U.K. Ltd (the provider) offers health assessments and healthcare plans to people aged over-18 years. It was registered by the Care Quality Commission under the Health and Social Care Act 2008 in September 2017, to provide the regulated activities Diagnostic and screening procedures, Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury. The provider is registered by the CQC in respect of some, but not all, of the services it provides. For example, services provided to people under arrangements made by their employer or relating to personal insurance cover are exempt by law from CQC regulation. Therefore, we were only able to inspect the services arranged directly by service users.
People registering to use the service complete an online questionnaire about their health and lifestyle. They are sent blood sampling kits, which are posted back to a laboratory for analysis. Alternatively, service users may attend a local clinic for the sampling, or a nurse or phlebotomist can visit them at home or at work to obtain the blood samples. The written health assessment reports are produced following a review of the laboratory tests and the health and lifestyle questionnaires. They are accessible by a secure online account or via a mobile telephone app.
The provider offers four different levels of service package. The basic one, which we were told most service users opt for, includes a report by a dietitian registered with the Health and Care Professions Council (HCPC). The other packages provide a report by a doctor registered by the General Medical Council (GMC), together with ongoing telephone health coaching by a dietitian for up to six months. No medicines or supplements are prescribed or dispensed. Since the service was established, approximately 5,400 health assessments have been provided, with more than 1,700 coaching calls being conducted. The service is provided mostly to people under corporate arrangements with their employers; this currently represents around 98% of the business. At the date of our inspection, approximately 2,500 people had used the service in 2019 under arrangements with their employer, while only 40 service users had contacted the provider directly.
Details of the service are available on the provider’s website - www.getlivesmart.com
The provider operates from office premises at 81 Rivington Street, London EC2A 3AY, where its managerial and administrative team of 14 staff are based. It has four female GPs and a male hospital consultant all of whom are registered by the GMC and seven female dietitians, registered by the HCPC. There are three contracted phlebotomists, one contracted phlebotomy assistant (people trained to take blood samples) and a contracted nurse. Although the clinical staff normally work remotely, private rooms are available at the premises for the dietitians to conduct telephone health coaching when necessary.
How we inspected this service
Before the inspection we gathered and reviewed information from the provider.
During this inspection we spoke to the provider’s Chief Medical Officer, Chief Technical Officer, the Clinical Operations Lead and the Senior Dietitian. The Chief Executive Officer who is also the registered manager was on leave but joined in part of the discussion by telephone. 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 reviewed the provider’s governance policies and looked at a number of healthcare records of people using the service. We received comments from three service users, submitted via our website, following our inspection being announced.
To get to the heart of service users’ experiences of care and treatment, we 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 therefore formed the framework for the areas we looked at during the inspection.