Meyerhealth Ltd

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection of Meyerhealth Ltd on 21 June 2022 under Section 60 of the Health and Social Care Act 2008. 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. This was the provider’s first inspection of the service since it registered with the Care Quality Commission (CQC).

Throughout the COVID-19 pandemic the Care Quality Commission (CQC) has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Speaking with staff in person, on the telephone and using video conferencing.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 21 June 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff on the telephone and using video conferencing prior to our site visit.

Meyerhealth Ltd is a small independent service, led by a single GP who specialises in dermatology, minor surgery and women’s health. Services include GP consultations, phlebotomy and minor surgical procedures, including the excision of moles and other skin lesions.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Meyerhealth Ltd provides a wide range of non-surgical aesthetic interventions and anti-ageing treatments, for example, anti-wrinkle injections, dermal fillers and thread vein treatments, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Meyerhealth Ltd is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury, Diagnostic and screening procedures and Surgical procedures.

The clinic manager 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.

Our key findings were:

• Medical staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• There were processes in place for the training, performance review and monitoring of staff. However, non-clinical staff had not received training or guidance in the identification of ‘red flag’ signs or symptoms of sepsis in patients.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Staff worked well together as a team and all felt supported to carry out their roles. There was a strong team ethos and culture of working together.
• The service encouraged and valued feedback from patients and staff. Feedback from patients was positive.
• Emergency medicines held on site were insufficient given the patient population to which services were provided. There was a lack of some emergency equipment available.
• There had been insufficient action taken to address some legionella, fire safety and health and safety risks which were managed by the host dental practice.
• Best practice guidance was not always followed in providing treatment to patients. For example, excised lesions were not routinely sent for histological review. There was a lack of clear process for tracking histology results.
• There were some processes to assess the risk of, and prevent, detect and control the spread of infection. However, staff immunisations were not monitored in line with current guidance.
• Medicines were stored securely, however fridge temperature monitoring processes did not ensure the correct temperature range for their safe storage.
• Policies provided up to date, relevant and sufficient information, to provide effective guidance to staff. However, policy content was not always reflected in processes undertaken within the clinic.
• There was a lack of evidence of clinical audit and regular auditing of clinical record keeping processes.
• There was a lack of effective governance and risk assessment processes in some areas. For example, with regard to prescribing of controlled drugs, the provision of phlebotomy services and processes for managing incoming test results.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

We took enforcement action and issued a warning notice against the provider in relation to Regulation 12(1)(2) Safe care and treatment.

We issued a requirement notice against the provider in relation to Regulation 17(1)(2) Good governance.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• Consider processes to confirm the identity of patients where appropriate.
• Review arrangements to access electrocardiogram (ECG) monitoring.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care