• Hospital
  • Independent hospital

Archived: Medical Arts for Cosmetic Surgery

Overall: Good read more about inspection ratings

Unit 3, Wilmington Close, Exchange Road, Watford, Hertfordshire, WD18 0AF (020) 7078 4378

Provided and run by:
Medical Arts for Cosmetic Surgery Limited

Important: The provider of this service changed. See new profile

All Inspections

28 and 30 November 2018

During a routine inspection

Medical Arts for Cosmetic Surgery is operated by Medical Arts for Cosmetic Surgery Limited. The service provides cosmetic surgery and outpatient consultations, including pain management. Facilities include one procedure room, a recovery room, and three consultation rooms.

The clinic provides surgery and outpatients. We inspected surgery and outpatients.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection (we gave staff 48 hours’ notice that we were coming to inspect) on 28 and 30 November 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this clinic was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service report.

See the surgery section for main findings.

Services we rate

We found safe, effective, caring and responsive were good, and well-led was requires improvement. This led to a rating of Good overall.

We found areas of good practice:

  • Staff cared for patients with compassion, kindness and respect. They made sure that people’s privacy and dignity needs were understood and always respected.
  • The clinic had enough medical, nursing and support staff with the appropriate skills, knowledge and experience to deliver safe and effective care, support and treatment.
  • The service continued to treat incidents and complaints seriously. Managers investigated them, shared lessons learned with staff, and made improvements to service provision where indicated.
  • Hygiene practices had improved and staff followed infection prevention and control practices to reduce risks to patients.
  • Risks to patients were assessed and their safety was monitored and managed so they were supported to stay safe.
  • The service had suitable premises and equipment and looked after them well. Managers had improved the arrangements for clinical waste and equipment maintenance.
  • The management team promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff worked well together and were committed to providing the best possible care for their patients.
  • Patients were supported to make informed decisions about their chosen procedures and treatments, and were given sensible expectations.
  • Patient records were clear, up-to-date and complete. They were easily accessible to staff.

We also found areas of practice that were outstanding:

  • Staff worked especially hard to make the patient experience as pleasant as possible. The consultant surgeon went above and beyond expectations to ensure patients were fully consulted and had realistic expectations before they agreed to perform any cosmetic surgery. They prepared a detailed electronic presentation for each patient’s planned surgery, which they went through during the consultation. Patients were encouraged to ask questions and could contact the consultant surgeon or clinic staff at any time. Detailed patient feedback was sought and any concerns or negative feedback received was reviewed immediately and improvements were made. Patient feedback was overwhelmingly positive about the registered manager and clinic staff, and the care they provided.

However, we also found areas of practice that require improvement:

  • The provider had not taken sufficient action to deal with some of the areas we told them they must improve following our last inspection. While there was a programme of clinical and internal audit in place, we found completed audits lacked detail and it was not clear how often risks were reviewed.

  • The provider did not have effective governance arrangements in place to assure themselves that nursing staff had current professional registration and had completed mandatory training. This was outstanding from the inspection in July 2017.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice. Details are at the end of the report.

    Amanda Stanford

    Deputy Chief Inspector of Hospitals (Central)

25 July to 8 August 2017

During a routine inspection

Medical Arts for Cosmetic Surgery Limited is operated by Medical Arts for Cosmetic Surgery Limited. Facilities include one operating theatre with a recovery facility and three consultation rooms.

The facility provides cosmetic surgery and a chronic pain management service. We inspected both the cosmetic surgery and the chronic pain management services. Day-case surgical procedures and outpatient appointments for preoperative and postoperative review, as well as pain management. In the reporting period of April 2016 to March 2017, there were 77 day-case episodes of care and 429 outpatient appointments. The outpatient appointments were a mixture of patients accessing the chronic pain management service, and cosmetic surgery outpatient consultations.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 25 July 2017, along with an unannounced visit to the hospital on 7 August 2017.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

We regulate cosmetic surgery services but we do not currently have a legal duty to rate them when they are provided as a single specialty service. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

  • All areas of the clinic were visibly clean and tidy.

  • All staff had received mandatory training.

  • Records were stored securely.

  • The consent process was very robust.

  • Patients received compassionate care and their dignity and confidentiality was respected.

  • All areas of the service had wheelchair access.

  • There was an open culture and staff worked well together.

  • The registered manager was visible and approachable.

However, we also found the following issues that the service provider needs to improve:

  • The theatre did not meet the Department of Health Technical Memorandum 03-01 in relation to ventilation systems. However, following our inspection we saw evidence that the theatre did meet requirements.

  • Venous thromboembolism assessments were not completed.

  • The National Early Warning Score system to identify deteriorating patients had not been implemented. However, following our inspection we saw evidence that the service had begun to implement this.

  • The World Health Organisation ‘Five Steps to Safer Surgery’ checklist was not used effectively. However, following our inspection we saw evidence that the checklist had been improved.

  • There was no exclusion criteria to determine patients’ eligibility for admission. However, following our inspection we saw evidence criteria was implemented.

  • No data on patient outcomes was collected.

  • Audits were not always thorough or identified the causes of areas of concern.

  • There was a lack of action plans attached to audits.

  • There were no arrangements in place for patients living with dementia or a learning disability.

  • There were no translation services available.

  • There was no governance framework in place.

  • Not all risks identified had mitigating actions.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected cosmetic surgery. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central)