Wimpole Aesthetic Centre

Wimpole Aesthetics Centre Ltd is operated by Wimpole Aesthetics (Medical) Ltd . The service did not provide in-patient facilities and patients did not stay overnight at the location. Facilities include two theatres, with one being used as a recovery room, clinic rooms, treatment rooms and a waiting area.

The centre provides elective non-major cosmetic surgery for adults and provides treatment for Lyme disease. The centre did not treat any patient under 18 years old in the reporting period. We inspected the service under the cosmetic surgery core service, we did not inspect the Lyme disease service under the medical core service framework.

We carried out an unannounced inspection on 22 August 2019. We inspected this service using our comprehensive inspection methodology to see if improvements had been made since the service was placed in special measures after the previous inspection conducted in October 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.

Summary

We rated Wimpole Aesthetic Centre Ltd as good overall. The service had improved since our last inspection conducted in October 2018 where we had placed the service into special measures; however, there were still some areas where the service could improve

We found the following areas had improved since the previous inspection:

• The centre had improved by providing mandatory training in all key skills to staff and ensured everyone completed it.
• The centre controlled infection risks and kept clinical areas clean. However, staff had only recently started to monitor surgical site   infection rates and screen new admissions for micro-organisms and could not provide data regarding this.
• The centre had improved by ensuring staff completed and updated risk assessments for each patient and removed or minimised risks.
• The centre had improved by ensuring staff kept suitable and appropriately detailed records of patients’ care and treatment.
• The centre understood how to manage patient safety incidents, staff recognised and reported incidents and near misses. Incident learnings and outcomes were shared and discussed with the wider team.
• The centre had improved by providing care and treatment based on national guidance and evidence of its effectiveness. Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way.
• The centre had improved by ensuring staff were competent for their roles. Managers appraised staff’s work performance and held meetings with them to provide support and development. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• The centre had improved by ensuring managers had the right skills and abilities to run a service providing high-quality sustainable care. The centre promoted a positive culture that supported and valued staff. The centre had improved its governance system and risk management system.

However, we found the following areas that required improvement;

• The provider did not formally monitor the effectiveness of care and treatment.
• The centre was still developing a strategy for what it wanted to achieve but had developed formalised values.
• The centre did not collect or use information for the purpose of service management and improvement
• The centre lacked a formalised regular approach to quality improvement.

We found sufficient improvement to remove the service from special measures.

Dr. Nigel Acheson

Deputy Chief Inspector of Hospitals

Wimpole Aesthetics Centre Ltd is operated by Wimpole Aesthetics (Medical) Ltd . The service did not provide in-patient facilities and patients did not stay overnight at the location. Facilities include two theatres with one being used as a recovery room, clinic rooms, treatment rooms and waiting area.

The centre provides elective non-major cosmetic surgery for adults. The centre did not treat any patient under 18 years old. We inspected the service under our cosmetic surgery core service framework.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 25 September 2018, followed by an announced visit to the centre on 4 October 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.

Summary

We rated Wimpole Aesthetic Centre Ltd as Inadequate overall. We inspected the service in March 2017 and did not have the power to rate the service at that time. We found areas of regulatory breaches and had concerns including; lack of screening new admissions, lack of governance structures, lack of employment checks and more which can be found in the previous inspection report. Although the service had improved in a limited way since our last inspection, we found some new areas of concern and there were still areas where the service still did not meet legal requirements.

We found the following:

• The centre had started providing mandatory training to all staff as it did not previously, however it was not ensuring staff were completing their training.
• The centre did not manage infection risk well. They did not screen patients for micro-organisms before procedures and did not monitor surgical site infection rates.
• The centre did not have a detailed policy regarding a deteriorated patient and did not have access to evacuation equipment.
• Staff did not complete VTE risk assessments for patients recommended by NICE guidance.
• Staff kept records of patients’ care and treatment, however they were of variable quality and not all aspects of the pathway were recorded.
• Staff recognised incidents and reported them appropriately, however there was no formalised system of reviewing incidents or sharing the learnings.
• The centre did not collect safety information and use this to improve the service.
• The centre did not fully provide care and treatment based on national guidance and evidence of its effectiveness.
• Staff did not record any assessments or observations for patients regarding pain.
• The centre did not monitor the effectiveness of care and treatment.
• The provider did not appraise staff’s work performance or hold supervision meetings with them to provide support and monitor the effectiveness of the service.
• The centre was unable to evidence that it took account of people's individual needs.
• Managers did not always have the right skills and abilities to run a service providing high-quality sustainable care.
• The centre did not have a vision for what it wanted to achieve.
• The centre still lacked a robust governance system and risk management system.
• The centre had limited engagement with patients regarding improving the service.

However;

• Staff had training on how to recognise and report abuse.
• Staff kept themselves, equipment and the premises clean.
• The centre had suitable premises and equipment and looked after them well.
• Patients received the right medication at the right dose at the right time.
• Staff of different kinds worked together as a team to benefit patients.
• Staff always had access to up-to-date and accurate information on patients’ care and treatment.
• The centre planned and provided services in a way that met the general needs of its patients.
• People could access the service when they needed it
• The centre treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
• The centre promoted a positive culture that supported and valued staff.

Following this inspection, I am placing the service into special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration

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 two requirement notices. Details are at the end of the report.

Edward Baker  

Chief Inspector of Hospitals