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Brigstock Skin & Laser Centre

Inspection Summary


Overall summary & rating

Updated 11 May 2018

We carried out an announced comprehensive inspection on 6 March 2018 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 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 providing well-led care in accordance with the relevant regulations

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.

The service provides medical treatment for a number of skin conditions, including eczema and psoriasis and minor surgery to remove cysts. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Brigstock Skin and Laser Centre also offers a range of aesthetic services not regulated by CQC including wart removal with liquid nitrogen, wrinkle reduction and laser hair removal.

The managing partner 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.

Twenty-two people provided feedback about the service, and the feedback was wholly positive.

Our key findings were:

  • Risks to patients were assessed and well managed. We found only one issue: an expired medicine which had been replaced but had not been removed from the clinic supply.
  • Audit was used to check care was delivered according to operating procedures.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There were arrangements to safeguard patients from abuse.
  • Staff were allowed regular time for personal development, weekly meetings with the clinic manager to review their progress and annual appraisals.
  • Patients said they were treated with compassion, dignity and respect.
  • Information about how to complain was available and easy to understand, although the clinic did not always follow its complaints policy consistently (in sending acknowledgments).
  • There was a clear leadership structure and staff felt supported by management.

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

  • Review the significant events policy to consider clarifying the guidance on applying the Duty of Candour.
  • Review the management of complaints to ensure the clinic policy is consistently applied.
  • Review the risks associated with the decision to conduct a standard (rather than an enhanced) Disclosure and Barring Service check for non-clinical staff acting as chaperones.
Inspection areas

Safe

Updated 11 May 2018

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

  • There was an effective system in place for reporting and recording significant events. This included arrangements for acting in line with the Duty of Candour, although the policy was not clear on the circumstances in which it applied.
  • Lessons were shared to make sure action was taken to improve safety in the service.
  • When things went wrong patients received reasonable support and truthful information.
  • The service had processes and practices in place to keep patients safe and safeguarded from abuse.
  • Risks to patients were assessed and well managed. The practice had considered and mitigated a number of different risks, including those related to recruitment. Clinical staff all received an enhanced Disclosure and Barring Service (DBS) check. Non-clinical staff received a standard DBS check, a decision that had not been risk assessed.

Effective

Updated 11 May 2018

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

  • Staff assessed needs and delivered care using clear operating procedures, developed in line with best practice guidance.
  • Costs and likely outcomes were discussed with patients before treatment commenced.
  • Audit was used to check care was delivered according to operating procedures.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff were allowed regular time for personal development, weekly meetings with the clinic manager to review their progress and annual appraisals.

Caring

Updated 11 May 2018

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

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available and their costs was available and easy to understand.
  • We saw staff maintained the confidentiality of patient information.

Responsive

Updated 11 May 2018

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

  • Patients said they found it easy to make an appointment.
  • The clinic requested feedback from all patients and results showed a high level of satisfaction with the service.
  • The service was well equipped to treat patients and meet their needs.
  • Information about how to complain was available and easy to understand, although the clinic did not always follow its complaints policy consistently as they did not consistently acknowledge complaints upon receipt.
  • Evidence showed the service responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Updated 11 May 2018

We found that this service was providing well-led care in accordance with the relevant regulations.

  • The service had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.
  • There was a clear leadership structure and staff felt supported by management. The service had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The partners encouraged a culture of openness and honesty. The service had systems in place to ensure that appropriate actions were taken in the event things went wrong. The provider was aware of the requirements of the duty of candour, although their policy did not make clear to which events it applied.
  • The service proactively sought feedback from staff and patients, which it acted on.
  • There was a focus on continuous learning and improvement at all levels.