• Hospital
  • Independent hospital

Archived: Whitethorn Fields MediClinic

Old Risborough Road, Stoke Mandeville, Aylesbury, Buckinghamshire, HP22 5XJ (01296) 614441

Provided and run by:
Whitethorn Fields MediClinic Limited

All Inspections

21 September 2016

During a routine inspection

We carried out an announced comprehensive inspection on 21 September 2016 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations .

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

Background

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Whitethorn Fields Medicentre was established in 2012. The clinic offers a consultation service for a wide range of cosmetic surgery treatments to adults. These treatments include aesthetic cosmetic consultations and treatment, cosmetic surgery consultation and minor cosmetic surgical procedures under local anaesthetic.

The provider established the clinic with a colleague and together they work as co-directors. There are two distinct halves to the clinic; one has the main purpose of providing a professional nipple (areola restoration) tattoos service for women following breast surgery and an aesthetic service, such as dermal fillers and laser hair removal. This part of the business was not inspected as it does not fall under the regulations. The second is the one run by Mr Ghosh to provide cosmetic surgery consultations and minor surgical procedures for cosmetic reasons, such as removal of skin tags or warts.

The objective of the company is to provide all patients with an outcome consistent with current best practice guidelines and individual expectations.

The provider attends the clinic for one afternoon and evening a week to conduct outpatient services and minor cosmetic surgery. The provider employs a registered nurse to assist with surgical procedures. The clinic only uses localised anaesthetic to perform cosmetic surgical procedures. The providers other employment is in a local NHS Hospital at other times. The registered nurse works in another healthcare establishment and completes her mandatory training and clinical supervision with this employer to remain current with clinical practice. The service has no beds. Facilities include a clinical treatment room and a consultation room.

We do not currently have a legal duty to rate cosmetic surgery service or the regulated activities they provide but we highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

Mr Sudip Ghosh is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider told us that the business been served a blight notice to vacate the premises. The provider was planning to close the business within 4-6 months and continue working in the NHS.

We spoke with 15 patients and five family members all of whom provided positive feedback about the service. Patients reported that they had received an excellent service and all staff members in the clinic were professional and caring.

Our key findings were:

  • The clinic was clean, tidy and welcoming with wheelchair access. We saw that good infection control practice was observed such as hand hygiene.
  • Patients were positive about their care and treatment. Although the provider did not have a system for collecting patient feedback, in order to use this information to monitor the quality of the service and to drive improvements.
  • A chaperone was available and patients were offered this choice. However, these staff members had not received chaperone examination training.
  • Equipment and medication that may be required in an emergency were accessible. However, there was no evidence that these pieces of equipment were checked when the clinic was open.
  • While there was an effective system for managing those medicine currently being used by the clinic, there was a large amount of medicine and stock consumables items no longer used that had expired and not been disposed of.
  • There were no service agreements in place for clinical equipment such as the examination/ treatment couch
  • The provider granted practising privileges to a doctor to perform hair transplants. We found the necessary compliance checks had been completed for this doctor; however, the provider was not clear regarding the accountability should something go wrong with this doctor’s practice.
  • The provider explained clinical procedures to his patients in easy to understand terms.
  • The provider followed the Department of Health 2009 guide to consent for examination or treatment and explained risks and benefits and used drawings to explain surgical procedures.
  • Advice was given such as reducing weight or cessation of smoking prior to procedures. The provider politely declined requests from patients for surgical procedures that were not considered in the best interest of the patient and gave clear explanation to the patient why the request had been refused.
  • The provider continued to work in the NHS and was up to date with mandatory training and could give examples of recent safeguarding and mental capacity act /deprivation of liberty safeguards training.
  • There was no formal governance system for the monitoring of the quality of the service

We identified regulations that were not being met and the provider must:

  • Ensure there is a fully effective stock rotation system that includes the removal and destruction of out of date stock medicine and consumables.
  • Introduce a governance framework that uses audits, review of incidents, complaints and patient feedback to review the quality of the service.

There were areas where the provider could make improvements and should:

  • Review the process for the checking and recording of the check for clinical equipment such as the emergency resuscitation equipment and the medicine fridge temperature.
  • Ensure the clinic chaperone has undertaken training so that they develop the competencies required. This training is to include roles and responsibilities and the policy and mechanism for raising concerns.
  • Ensure that all clinical equipment is serviced in accordance with the manufacturer’s instructions.
  • Review the complaints monitoring process and consider implementing a formal written process for handling complaints.

6 June 2013

During a routine inspection

We spoke with one person who had received treatment. We observed positive interaction between clinic staff and people who arrived for treatment or made appointments for future treatment. We looked at patient satisfaction survey returns from people who used the service. People said or stated they were impressed with the quality of staff and the care and treatment they received. They said they had sufficient information about their treatment options. We found there was clear and transparent information about the costs of treatments available to people before they commenced. When we looked at patient care records we found consent forms were in place and signed for each individual treatment. This showed people were involved in decisions about their care and were provided with the necessary level of detail, including about any potential risks involved.

We found the premises, environment and equipment were clean, well designed and maintained. Equipment in use had been regularly serviced where necessary and policies and procedures were in place to ensure people's health safety and welfare were maintained and protected.

The records we saw were satisfactory and fit for purpose. We saw the completion of records was monitored, for example through team meetings. We found good practice was reinforced through staff training.