Archived: National Migraine Centre

Updated 2 August 2018

National Migraine Centre is a charitable organisation that provides private and voluntary-funded medical services in the Royal Borough of Kensington and Chelsea in London, and treats both adults and children. The address of the registered provider is 226 Walmer Road, London W11 4ET. National Migraine Centre is registered with the Care Quality Commission to provide the regulated activity: treatment of disease, disorder or injury. Regulated activities are provided at one location.

The organisation is run by a board of eight directors. One of the directors is the Chair and the nominated individual for the provider. One of the directors is the Chief Executive of the organisation. The registered manager is one of the doctors leading the service. 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 a 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 is housed within leased premises on the ground floor. The premises consist of a patient waiting area, three doctors’ consultation rooms, a quiet room, three patient toilets including one with disabled facilities and a staff office and meeting room. The service is open for pre-booked consultations on Thursday and Friday from 9am to 5pm. Reception and telephone opening hours are between 9am to 5pm, Monday to Friday.

Regulated services offered at National Migraine Centre include assessment and treatment of headache disorders including migraine. Treatments may include prescribing of medicines, lifestyle advice and modifications, Botox injections and greater occipital nerve blocks.

Since its inception in 1980, National Migraine Centre has treated over 52000 individual patients. There are approximately 50 patient appointments per week.

The staff consist of five part-time doctors. The clinical team is supported by the chief executive, an operations director, a clinic manager and an apprentice. There are also a number of volunteers that are recruited to assist with the development of the service on non-clinic days.

How we inspected the service:

Our inspection team on 31 May 2018 was led by a CQC Lead Inspector and included a GP Specialist Advisor.

Before visiting, we reviewed a range of information we hold about the service.

During our visit we:

• Spoke with two doctors.
• Spoke with the chief executive, operations director and the clinic manager.
• Looked at the systems in place for the running of the service.
• Viewed a sample of key policies and procedures.
• Explored how clinical decisions were made.
• Made observations of the environment.
• Reviewed feedback from 57 patients including CQC comment cards.

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

Updated 2 August 2018

We carried out an announced comprehensive inspection on 31 May 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 providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was 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 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.

National Migraine Centre is a charitable organisation that provides private and voluntary-funded medical services in the Royal Borough of Kensington and Chelsea in London. Services are provided to both adults and children. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical practitioner, including the prescribing of medicines.

We received feedback from 57 people about the service, including comment cards, all of which were highly positive about the service and indicated that patients were treated with kindness and respect. Staff were described as empathetic, caring, thorough and professional.

Our key findings were:

• There were arrangements in place to keep patients safe and safeguarded from abuse.
• Health and safety and premises risks were assessed and well-managed.
• There were safe systems for the management of medicines
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
• The premises were clean and hygienic.
• The service had systems for recording, acting on and improving when things went wrong, although it was not always clear whether all incidents were recorded.
• Assessments and treatments were carried out in line with relevant and current evidence based guidance and standards.
• There was evidence of a range of quality improvement measures.
• Staff had the specialist skills and knowledge to deliver the service.
• Staff treated patients with kindness, respect, dignity and professionalism.
• Patients were able to book appointments when they needed them.
• The service had a clear procedure for managing complaints. They took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• Leaders had the skills and capacity to deliver the service and provide high quality care.
• Staff stated they felt respected, supported and valued. They were proud to work in the service.
• There were clear governance arrangements for the running of the service.
• The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.
• The service asked staff and patients for feedback about the services they provided.
• The provider had a number of systems to enable learning, continuous improvement and innovation.

There were areas where the provider could make improvements and should:

• Review the systems for recognising, reporting, recording and acting on incidents and significant events.
• Monitor the system for reviewing, sharing and taking action on safety alerts.
• Monitor the system for assessing and managing risks related to infection control.