17 October 2019
During a routine inspection
This service is rated as Good overall. (Previous inspection 08/2018 – Not Rated).
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Outstanding
We carried out an announced comprehensive inspection at The Functional Gut Clinic on 17 October 2019. We previously inspected the service on 8 August 2018 at which time we identified concerns in regard to whether the service was safe and served a Requirement Notice under regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The full comprehensive report on the 8 August 2018 inspection can be found by selecting the ‘all services’ link for The Functional Gut Clinic on our website at www.cqc.org.uk.
The practice sent us a plan of action to ensure the service was compliant with the requirements of the regulations. We carried out this comprehensive inspection on 17 October 2019 to review the practice’s action plan, look at the identified breaches set out in the Requirement Notice and to rate the service.
We based our judgement of the quality of care at this service on a combination of:
•what we found when we inspected
•information from our ongoing monitoring of data about services and
•information from the provider, patients, the public and other organisations.
The Functional Gut Clinic is an independent clinic based in central London and offers advanced diagnostic and screening procedures in alimentary (relating to nutrition) and gastrointestinal (relating to the stomach and intestine) healthcare services for adults and children.
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 received five 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:
•Action had been taken since our last inspection such that an appropriate range of emergency medicines and equipment were readily accessible. Fire risks were now also routinely assessed and acted upon; and action had also been taken in relation to risks associated with a bacterium called Legionella which can contaminate water systems in buildings.
•There were adequate systems for reviewing and investigating when things went wrong. For example, we saw evidence the service identified lessons, shared learning and took action as necessary to improve safety.
•The service routinely reviewed the effectiveness and appropriateness of the care it provided. For example, we saw evidence that audits were used to ensure care and treatment were being delivered according to evidence-based guidelines.
•Staff involved and treated people with compassion, kindness, dignity and respect.
•Patients could access care and treatment from the service within an appropriate timescale for their needs.
•The leadership, governance and culture promoted the delivery of high-quality person-centred care.
We saw the following examples of outstanding practice:
- We noted the Functional Gut Clinic was the first gastrointestinal service to have been granted United Kingdom Accreditation Service (UKAS) accreditation under the ‘Improving Quality in Physiological Services’ (IQIPS) programme. The service’s clinical director spoke positively about how the annual accreditation programme drove improvements in patient focussed and high quality care in areas such as performance of tests by clinical staff and observation of staff interactions with patients.
- The service had developed home breath test kits for patients to enable to carry out self-testing at home instead of needing to attend the clinic for a considerable amount of time. They had put together kits that fitted through standard letterboxes to make postage easy, both to and from the patient. The system had been tested by a clinician from the service before being rolled out to patients. We saw approximately 70% of patients were choosing to use this method of testing.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care