The Care Quality Commission (CQC) has rated Queens Clinic in Westminster as inadequate for the second consecutive time, following an inspection that took place in January. The service has also been suspended by CQC from treating people in order to protect the safety and welfare of those using the service.
Queens Clinic is a private gynaecological service, run by Mr Ahmed Ismail. It provides private consultations to adults, services offered includes gynaecological diagnostic and minor surgery procedures.
This announced comprehensive inspection was carried out to follow up on breaches of regulation that CQC found at the Queens Clinic’s last inspection.
Following this inspection, as well as the overall inadequate ratings, they have again been rated as inadequate for how effective and well-led they are. The safety rating for the service has dropped from requires improvement to inadequate. The service has again been rated as good for being responsive. The service was not rated on how caring it is due to insufficient evidence so retains its previous rating of good.
CQC took urgent action to suspend the provider as it believed people were at the risk of significant harm if it didn’t do so. CQC has taken further enforcement action, which will be reported on when we are legally able to do so.
Antoinette Smith, CQC deputy director of operations in London, said:
“It was disappointing to find that the same level of poor care has remained at Queens Clinic since our last inspection. We found the same inadequate leadership that had still not taken action to address our serious concerns around people’s safety and the quality of the care being provided. This is why we have taken urgent action to suspend the service to keep people safe from harm.
"We were concerned to find that the service didn't follow its safeguarding policy and protocol to keep people safe from neglect and abuse. For instance, after looking at records and talking to staff we found that the service didn’t following their own policy in relation to female genital mutilation. A thorough assessment to identify any risk should have been carried out. Depending on the risk, a referral should also have been made either to report a crime or to take action to ensure the safety and well-being of the person and their family.
"It was raised in our previous inspection that the service didn't have effective risk assessments in place and no improvements has been made. The service carried out procedures with local anaesthesia but if there was a bad reaction to it, the surgeon was the only regulated health professional there to handle it. They hadn't properly assessed the risks of not having a second doctor available.
“When we reviewed the clinical records and consent forms, it was often unclear which procedures were performed or how consent was obtained, including how risks were explained and information provided to people.
“In one example, records showed that a person attended a procedure for vaginal rejuvenation, but the consent form didn't contain details of it. We asked the doctor if this was a cosmetic procedure. The doctor said it wasn't and that it was needed for medical reasons. However, we found conflicting information on the record that it was for cosmetic reasons. Mr Ahmed Ismail wasn't registered with CQC to provide this surgery for cosmetic reasons.
“This service failed to deliver care and treatment up to the standards people should be able to accept, which left us with no option but to use our enforcement powers and suspend them from operating.
“We will continue to monitor Queens Clinic and won’t lift our suspension until we’re assured that their care and treatment provided are safe and effective. If we return and find there are not enough improvements made, we will not hesitate to take further action even if that means taking steps to cancel their registration.”
Inspectors also found:
- The clinical records system only searches by name. So, if there was a warning about a medicine given to a person, there would be no way to identify them in the database
- In some instances, medicines had been prescribed without a clear rationale in the medical record
- The service hadn’t reviewed how effective and appropriate care was provided
- The provider wasn't registered for surgical procedures regulated by CQC, and they told us that they would stop any surgical procedures immediately before they have completed the registration
- There wasn't a service manager at the time of the inspection, it was unclear who had the responsibility for the operational management of the clinic.
However:
- Staff treated people with compassion, kindness, dignity and respect
- People were able to access care and treatment from the service and an adequate complaints system was in place.