Archived: Aesthetic Beauty Centre - Newcastle-upon-Tyne

Updated 16 July 2021

Aesthetic Beauty Centre – Newcastle upon Tyne is operated by Aesthetic Beauty Centre LLP. The service opened in 2010. It is a private independent cosmetic surgery service in Newcastle upon Tyne, Tyne and Wear. The service primarily serves the communities of Tyne and Wear. It also accepts patient self-referrals from outside this area.

The service also offers cosmetic procedures such as dermal fillers and laser hair removal. We did not inspect these services.

The service has had a registered manager in post since 2010.

Aesthetic Beauty Centre – Newcastle upon Tyne provides the following regulated activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury.

However, all the regulated activities above were subject to a condition that the provider must only undertake minor surgical and cosmetic procedures under local anaesthesia as detailed in its statement of purpose for service users aged 18 or over at this location.

We have inspected this location three times in the past 12 months and at each inspection CQC took enforcement actions.

We inspected this location in September 2019 and imposed conditions to prevent the provider from carrying out surgical procedures requiring local anaesthetic or sedation until 4 January 2020. The provider appealed this decision and CQC were required to attend a tribunal where the panel ruled conditions would be extended until 4 April 2020.

We re-inspected the service at the provider’s request in December 2019 and in January 2020 and although the provider had made some changes, we found these were insufficient to provide adequate patient safety and the conditions remained unchanged.

We planned to carry out a full comprehensive inspection in March 2020, prior to the conditions expiring. However, CQC conditions were overtaken due to government restrictions on all independent health providers during the Covid-19 pandemic. The provider assured CQC, in line with government restrictions, they would remain dormant until 01 July 2020. The provider agreed to inform CQC two weeks prior to re-commencing services to allow sufficient time for a full comprehensive inspection before the first patients were seen and procedures were booked. We maintained engagement and monitoring activity with the provider and staff provided lists of consultations which showed the service had recommenced prior to 01 July 2020.

We carried out this responsive, focused inspection to ensure improvements to patient care and safety had been made.

Updated 16 July 2021

Aesthetic Beauty Centre – Newcastle-upon-Tyne is operated by Aesthetic Beauty Centre LLP. The service is registered to provide a range of surgical and cosmetic procedures under local anaesthetic or sedation to fee paying patients over 18 years old.

The service is situated in a large detached house which has been converted into a clinic, that is wheelchair accessible to ground floor level (but without ramps) and is located conveniently for access to local public transport networks, but also has on street parking.

There is a downstairs reception room and waiting room, a consulting room and unisex toilet. On the first floor there was a theatre, pre-theatre room, shower/toilet room, clean and dirty utility, and recovery room, together with a room used by staff for administrative purposes.

We inspected this service using our responsive inspection methodology following information we received from the provider that confirmed they would recommence regulated activities from 01 July 2020. We carried out a short notice announced inspection on 27 July 2020 along with virtual interviews on-line with staff on 28 July 2020.

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 location is Aesthetic Beauty Centre – Newcastle upon Tyne. Where our findings on Aesthetic Beauty Centre – Newcastle upon Tyne – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the Aesthetic Beauty Centre – Newcastle upon Tyne service level.

Following this inspection, we identified areas where the provider must make improvements. Details are at the end of the report.

Services we rate

We had not previously rated this service which was registered in October 2010. As this was a focussed responsive inspection, we looked at specific areas and did not cover the whole domains on key questions.

Therefore, we inspected but did not rate the service.

We found the following issues, where the service provider was not meeting regulations:

• The recovery environment did not meet infection prevention and control best practice in line with national guidance. This had been identified at previous inspections in September and December 2019 and again in January 2020. At this inspection there had been some improvements made to the environment, but these remained insufficient to provide adequate infection prevention and control practice.
• The provider had stopped decontamination of their own surgical instruments but had not been able to provide CQC with a copy of a contract or service level agreement to ensure surgical instruments were decontaminated in line with regulations.
• Previous inspections had identified patient risk assessments were not always completed and updated in line with best practice. We found this had not improved at this inspection.
• Previous inspections had identified operation notes were not recorded on appropriate documentation for their purpose. Due to this it meant notes were difficult to find and not easily legible. At this inspection we found current patient records given to CQC by the provider were not always updated from consultations which had place up to a year ago and legibility remained very poor.
• There were no environmental risk assessments and no risk assessments carried out for new equipment. There was equipment stored in clinical areas and the provider had not recognised this as a risk. A new external staircase had been built but staff had not recognised the need to carry out a risk assessment.
• Previous inspections identified policies within the service did not reflect the environment or accurate processes used within the service. At this inspection we found a new policy and procedure manual had been produced but the old policies remained in place and there were still policies where roles and the environment were not accurately reflected. New patient pathway documentation referred to policies that did not exist or remained unchanged.
• Previous inspections had identified there was no audit of pre-operative risk assessments to ensure these were thorough and complete. At this inspection we found that although staff told us they had carried out records audits, patient pre-assessment documentation was still not fully completed, signed or dated even though patients were booked for surgery.
• Previous inspections identified the leadership team were unable to demonstrate full understanding of their responsibilities in carrying out or managing regulated activities and meeting the standards required by the HSCA regulations. At this inspection we found this had not improved. Some responsibilities had been delegated to a business consultant including the creation of a new policy and procedure manual, but the leadership team were still unable to demonstrate a full understanding of their roles and responsibilities as providers of a healthcare service.
• The provision of out of hours care was not robust. At previous inspections we were not assured a patient who required urgent treatment, when the surgeon was operating at other locations, would receive care from medical professionals with the appropriate skills and competence. Although the provider assured us there was an agreement in place with a local NHS trust, the formal document to confirm these arrangements could not be provided to us.
• There was out of hours cover provided at another facility where procedures were carried out under practising privileges. However, patients did not stay at the facility overnight following procedures.

However:

• The provider had addressed some areas of infection prevention and control. These included replacement of the sink in the theatre, provision of a handwashing sink in the recovery room, and washable hard flooring in clinical areas.
• Medicines were stored securely and correctly.

Following this inspection, we were not assured the provider had taken sufficient action to comply with all of the Health and Social Care Act (HSCA) 2008 Regulations (2014) and there was an ongoing risk of harm to patients undergoing cosmetic surgery procedures at this location.

We issued two fixed penalty notices on 29 July 2020 for failure to notify CQC as required under the Regulations 12 and 15 of the Care Quality Commission (Registration) Regulations 2009. These were paid by the provider on 13 August 2020

We issued a notice of proposal to cancel the registrations of the provider and registered manager on 25 August 2020. The provider submitted representations to appeal the notices on 22 September 2020. The representations were not upheld and a notice of decision to cancel the registration of both the provider and the registered manager was issued on 12 October 2020.

The provider appealed to the first-tier tribunal in November 2020 against both notices, however, withdrew the appeal on 30 June 2021. Therefore, the notice of decision to cancel the registration of the provider and registered manager took effect on 12 July 2021.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

Updated 16 July 2021

Are services safe?

Care premises, equipment and facilities were unsafe.

Staff did not have knowledge of appropriate regulations or apply national guidelines to ensure patients were safe at all times. The service did not have the correct equipment, or knowledge of regulations to keep patients safe.

The service did not control infection risk well, although staff kept most equipment and the premises visibly clean.

Staff did not always complete and update risk assessments for each patient to remove or minimise risks.

Staff did not always keep detailed records of patients’ care and treatment. Records were not always clear, or up to date.

However:

Staff stored and managed medicines well.

Are services well-led?

The leadership team were unable to demonstrate full understanding of their responsibilities in carrying out or managing regulated activities and meeting the standards required by the HSCA regulations. Leaders did not run the service well. They did not use reliable information systems including organisational policies and processes for staff to follow.

Not all staff understood the service’s vision and values, and how to apply them in their work. Processes were not always focused on the needs of patients receiving care.

Leaders did not operate effective governance processes throughout the service. Staff were not always clear about their roles and accountabilities.

Staff told us they were committed to improving services continually. However, leaders lacked insight and knowledge of regulations to make sufficient improvements.

Leaders and teams did not identify or escalate all relevant risks and issues or identify actions to reduce their impact. There were insufficient plans to cope with unexpected events.

The service did not provide care and treatment based on national guidance and evidence-based practice. Managers did not check to make sure staff followed guidance.

The provider failed to manage the expectations of patients. However, they engaged well with patients and staff felt respected, supported and valued.