The Care Quality Commission
  • Hospital
  • Independent hospital

Signature Clinic - Central London Also known as Signature Medical Ltd

Overall: Inadequate read more about inspection ratings

Unit 11, 73 St Charles Square, London, W10 6EJ (020) 8191 0470

Provided and run by:
Signature Medical Limited

All Inspections

During an assessment under our new approach

Date of assessment 28 August to 13 September 2024. We carried out this assessment in response to enforcement action that we had taken against the service at our previous inspection in August 2023. The service was performing badly at the time of our previous inspection. We served the provider a warning notice under Section 29 of the Health and Social Care Act 2008. The Warning Notice told the provider they were in breach of Regulations 12 Safe Care and Treatment and Regulations 17 Good Governance, and gave the provider a timescale to make improvements to achieve compliance. We inspected seven quality statements across the safe, effective, responsive and well-led key questions. Following this inspection, there was no change in rating, as inspectors only looked at compliance with the previously issued Warning Notice. The service had made all of the required improvements in response to the warning notice. Staff made improvements to infection control processes. The service ensured that medicines and treatments were safe and met people’s needs, capacities and preferences. There were effective systems in place for recording and investigating clinical incidents that occurred in the service, and processes were in place for sharing any learning with staff. There was evidence that staff were competent for particular clinical skills. Staff supported patients to make informed decisions about their care and treatment. There was an effective complaints system in place that was accessible to patients. There were improved governance processes, and a positive culture.

August 15 2023

During a routine inspection

This was the first time we rated this service. We rated it as inadequate because:

  • Over the last 12 months the service did not have enough suitably qualified staff to care for patients and keep them safe.
  • There was poor adherence to infection prevention controls.
  • The service did not manage medicines well and we were not assured that staff were following the services policies when administering medicines to patients.
  • The service did not keep good patient records, all hand-written notes in patient care records that were reviewed were illegible.
  • We saw a lack of clinical incidents and we could not be assured how well clinical incidents were recorded. We were not assured that lessons could be learnt from them.
  • Managers did not monitor the effectiveness of the service or made sure staff were competent. Staff did not have access to key information. Pain relief was offered to patients when they needed it, however medications were often handed out by unqualified staff. Staff did not advise patients on how to lead healthier lives.
  • Negative feedback was discouraged, and patients were ill-informed about the complaints procedure.
  • Leaders did not support staff to develop their skills.
  • Staff did not understand the service’s vision and values, or how to apply them in their work.
  • Governance processes were not robust, and we found incomplete key lines of communication between the senior leadership team and junior staff. There was a lack of formal recording in meeting minutes to cascade information. Not all risks identified on the inspection were known to the provider.
  • The service did not engage well with patients or staff to plan and manage services.

However:

  • For the majority of patients staff treated them with compassion and kindness. They provided emotional support to patients, families and carers, whilst they were at the clinic. The aftercare team supported patients well post operatively.
  • Staff worked well together for the benefit of patients.
  • Staff felt respected, supported and valued by members of senior leadership team.
  • The service provided refreshments for patient and friends and family.
  • After-care was available seven days a week.