Staianoplasticsurgery

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that patients had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patients were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment the rating remained good. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The service made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients filled in a medical questionnaire which included information about their physical and mental health. Where required, the service referred patients to a counsellor free of charge to support them and see if they were a suitable candidate for surgery. They offered support depending on the outcome.

Patients were confident that their individual needs had been appropriately assessed and were fully understood. We saw patient feedback that showed surgeons ensured all care was individualised and decisions were made with the patients. The surgeons offered unlimited multiple appointments to ensure patients were prepared for their surgery and knew the risks.

We observed a minor operation and the patient’s pain was assessed throughout the procedure. All patients who underwent operations at the affiliated hospital were telephoned by the nurse post operatively to check their pain and recovery prior to being seen in the clinic.

Patients were involved in the assessment of their needs, and support was provided where required. Patients self-referred to the service and there was a comprehensive approach to assessing the needs of the patient. Staff were passionate about providing up to date evidence-based practice in line with national guidance to make sure patients had the best outcomes for them. However, this was not reflected in their policies which did not always reference national guidance. Please refer to delivering evidence-based care and treatment for further details.

The service planned and delivered patient’s care and treatment with them, including what was important and mattered to them. However, the provider did not ensure the policies were up to date and reflected current evidence-based good practice and standards.

The policies within the clinic lacked detail, version control and were out of date. For example, the safeguarding policy was dated January 2017 and did not contain the correct contact details for the local safeguarding contact, the consent policy did not detail the 2-stage consent and 14 day cooling off period all patients adhered to in line with best practice and there was no policy for the deteriorating adult. Please refer to the consent section in effective for further details around consent which we saw was undertaken effectively.

Not all policies we reviewed referenced national guidance. For example, the sepsis policy did not reference UK Sepsis Trust or the National Institute for Health and Care Excellence (NICE). We fed this back to the provider who told us they would do a full review of their policies and procedures. We saw evidence following the inspection that some policies had been updated and included a version control and date and contained references to national guidance.

Patients received care, treatment and support that was evidence-based and in line with good practice standards. All care was consultant-led and the service only worked with consultants who were on the general medical council specialist register for plastic surgery.

Staff and leaders were supported to keep up to date with new and innovative evidence-based approaches to care. Consultants were members of the British Association of Aesthetic Plastic Surgeons (BAAPS), which promoted good practice and provided access to high standards of training, ethics and governance. The lead consultant was also a member of CAPSCO (Consortium uniting Aesthetic Plastic Surgery Clinic Owners), a professional network for aesthetic plastic surgery clinic owners, which enabled regular peer discussion and support through secure communication channels. The lead consultant had obtained colleague feedback as part of their annual appraisal and one colleague stated “They have great insight and take trouble to work in concert with the peer community. They thereby are abreast of standards and current practice.”

The clinic had an audit schedule in place; however, this was not effective in identifying all risks. Staff used local governance processes to monitor compliance and standards, but these required further improvement. Audits reviewed during the inspection showed 100% compliance for 2026 and covered areas such as clinical documentation, consent, medicines management and hand hygiene. Although not all staff were aware of the audits undertaken or the results. There were no health and safety or infection prevention and control environmental audits in place. As a result, staff were not aware of some risks identified during the inspection, including the absence of a fire risk assessment for the building.

The service worked well across teams and services to support patients. Staff made sure patients only needed to tell their story once by sharing their assessment of needs when patients moved between different services. All staff knew each patient and their journey of care, and this meant that patients felt they had a personal experience.

Staff had access to the information required to assess, plan and deliver care appropriately. With patient consent, the service contacted patients’ GPs to inform them of procedures undertaken. The service also had referral arrangements with a counsellor specialising in body image, and patients were referred pre‑operatively where concerns were identified through medical questionnaires.

Information was shared appropriately between services to ensure continuity of care. Where patients underwent surgery at an associated hospital, relevant information was shared in advance. Care was well coordinated, with teams working collaboratively, and pre‑procedure checks and eligibility criteria were aligned with the operating hospital to ensure patients were safe to proceed with surgery.

The service maintained effective communication with the hospital where patients underwent surgery. For example, the hospital owner informed the team of recent personnel changes and involved them in discussions, which promoted collaborative working and made staff feel valued.

The service supported patients to manage their health and wellbeing and promoted healthier lifestyles. Patients were advised to stop smoking or vaping prior to surgery, and the associated hospital did not undertake procedures under general anaesthetic for patients who smoked. Patients were encouraged to maintain a healthy weight to reduce surgical risks, and where weight loss was identified as beneficial, the service provided advice and support and recommended this prior to proceeding with surgery. Staff described how they had supported a patient over a period of time to reduce their body mass index to a safe level prior to surgery.

Staff worked with patients on an individual basis and signposted them to sources of help and guidance. The clinic provided extensive information about the procedures and aftercare, which included healthy lifestyle information.

The service supported patients to manage their health and wellbeing and promoted healthier lifestyles. Patients were advised to stop smoking or vaping prior to surgery, and the associated hospital did not undertake procedures under general anaesthetic for patients who smoked. Patients were encouraged to maintain a healthy weight to reduce surgical risks, and where weight loss was identified as beneficial, the service provided advice and support and recommended this prior to proceeding with surgery. Staff described how they had supported a patient over a period of time to reduce their body mass index to a safe level prior to surgery.

Staff worked with patients on an individual basis and signposted them to sources of help and guidance. The clinic provided extensive information about the procedures and aftercare, which included healthy lifestyle information.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Patients understood their rights around consent to the care and treatment they were offered. There were systems and practices to ensure patients understood the risks of the surgery they requested. This helped them make an informed decision. The patients could have unlimited appointments with the surgeon until they were ready to proceed.

Patients were provided with clear, accessible information about surgical options and were given appropriate time and support to make informed decisions. Information was shared in a range of formats, including videos, text messages and emails. Patients received comprehensive information to support decision‑making, including detailed guidance such as the ‘Staiano 10‑step’ process for selecting breast implants.

The service ensured that patients understood the potential impact and risk of their procedure and were given a cooling off period of at least for 14 days between the decision to have surgery and the procedure taking place. This was in line with professional standards.

Staff understood the importance of ensuring that patients fully understood what they are consenting to and the importance of obtaining consent before they delivered care or treatment. The consultant saw the patient at least twice prior to undertaking surgery; this 2-stage consent process for major surgery was in line with professional standards. The lead surgeon had undergone consent training.

Patients undergoing minor surgery through the ‘see and treat’ service completed consent on the day of treatment. Prior to attendance, patients contacted the clinic and provided images of the condition, such as a mole for removal. The service provided targeted pre‑procedure information in advance, including videos and written information about the clinic and the planned procedure. Patients were then booked for surgery, with consent obtained on the day of treatment.

Staff clearly recorded consent in the patients’ records. We looked at 5 sets of records, and the consent was completed thoroughly within each set of notes. This was audited monthly and results were consistently 100%.

While the consent policy outlined key principles of informed consent, it did not fully reflect professional guidance for cosmetic surgery. It lacked reference to 2‑stage consent, cooling‑off periods, mental health assessment, and capacity considerations. The policy also did not clearly describe the consent process for patients using the ‘see and treat’ service.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. The service had a mental capacity policy. Staff were trained in the Mental Capacity Act.