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Inspection Summary


Overall summary & rating

Outstanding

Updated 16 October 2019

Bella Vou Ltd is operated by Bella Vou Ltd. The service sees patients on a day case basis and has no overnight beds. Facilities include three operating theatres, one procedure room, three consultation rooms and a quiet room.

The service provides cosmetic surgery to patients over the age of 18. We inspected surgery services.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 8 and 12 August 2019.

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.

Services we rate

We rated this service as Outstanding overall.

  • The service had enough medical, nursing and support staff with the right skills, knowledge and experience to keep people safe from avoidable harm and to provide the right care and treatment.

  • Staff continually cared for patients with compassion, kindness and respect. They made sure that people’s privacy and dignity needs were understood and always respected.

  • The service treated incidents and complaints seriously. Managers investigated them, shared lessons learned with staff, and made improvements to service provision where indicated.

  • Staff followed infection prevention and control practices to reduce risks to patients.

  • Risks to patients were assessed and their safety was monitored and managed, so they were supported to stay safe.

  • The service had suitable premises and equipment and looked after them well. Since our last inspection, managers had improved the arrangements for clinical waste and equipment maintenance.

  • The management team promoted a highly positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff worked well together and were committed to providing the best possible care for their patients.

  • Patients were fully supported to make informed decisions about their chosen procedures and treatments, and were given sensible expectations.

  • Patient records were clear, up-to-date and complete. They were easily accessible to staff.

  • The service offered a cosmetic surgery clinical fellowship which is rare in a small service. These positions were usually offered in larger services. This reflected the high regard fellow plastic and reconstructive surgical specialists held of this service.

  • Staff worked especially hard to make the patient experience as pleasant as possible. Staff recognised and responded to the holistic needs of their patients from the first referral before admission to checks on their wellbeing after they were discharged from the hospital.

However, we also found areas of practice that require improvement:

  • The provider should make sure they store medical gas cylinders that complied with its medicines management policy and the Department of Health Technical Memorandum (HTM) 02-01 Cylinder for storage and handling, and Health and Safety at Work Act 1974.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

Inspection areas

Safe

Good

Updated 16 October 2019

We rated safe as Good because:

  • Staff assessed risks to patients, monitored and managed their safety so they supported patients to stay safe.

  • Patient safety incidents were managed in line with best practice.

  • Medical staffing levels were appropriate for the procedures performed.

  • The service had enough nursing and support staff to keep people safe from avoidable harm and abuse, and to provide the right care and treatment.

  • Staff kept accurate records of patients’ care and treatment.

  • Staff understood how to protect vulnerable patients from abuse.

  • The service provided mandatory training in key skills to staff. Staff employed by the service had completed mandatory training.

  • Infection risk was controlled in line with best practice.

  • Premises and equipment were suitable for purpose and were well looked after.

  • There were safe arrangements for the management of medicines.

However:

  • The storage of medical gases did not always comply with local and national guidance.

Effective

Good

Updated 16 October 2019

We rated effective as Good because:

  • Care and treatment provided was based on national guidance.

  • Staff had the skills, competence and experience to deliver effective care, support and treatment.

  • Patients were supported to make informed decisions about their chosen procedures and treatments.

  • Staff assessed and monitored patients regularly to see if they were in pain. They provided patients with relevant pain relief.

  • Staff worked together as a team to benefit patients. Doctors, nurses and support staff supported one another to provide good care.

  • Managers monitored the effectiveness of care and treatment and used the findings to make improvements.

  • Patients were encouraged to live healthier lives and manage their own health, care and wellbeing.

  • Staff gave patients enough food and drink to meet their needs.

  • The service’s opening hours and out of hours arrangements were enough to make sure effective care was available to patients.

However;

  • The provider’s resuscitation policy was not in-date and their consent to treatment policy did not reflect only the age group specific to the services they provided.

Caring

Outstanding

Updated 16 October 2019

We rated caring as Outstanding because:

  • Staff truly respected and valued people as individuals and empowered them as partners in their care.

  • Staff continually cared for patients with compassion. Feedback from patients was continually positive about the way staff treated them. People thought staff went the extra mile and the care they received exceeded their expectations.

  • There was a strong, visible person-centre culture. Staff were highly motivated and inspired to provide care that is kind and promoted people’s dignity.

  • Relationships between people who used the service, those close to them and staff were strong, caring and supportive. Staff highly valued these relationships and embedded this into their care and treatment. Leaders promoted this.

  • Staff continually recognised and respected people’s personal and emotional needs. They always took account of these and provided emotional support to minimise people’s distress.

  • Staff made sure patients and those close to them were fully involved in decisions about their care and treatment.

Responsive

Outstanding

Updated 16 October 2019

We rated responsive as Outstanding because:

  • The services always made sure they provided services that reflected people’s needs. Services were always planned and delivered in a way that met their needs. The importance of flexibility, choice and continuity of care was reflected in the services.
  • Patients’ individual needs were always considered.
  • People could easily access the service when they wanted. Patients had access to the right care at the right time. Access to care was managed to take account of patient’s needs, including those with urgent needs.
  • Waiting times and delays were minimal and managed safely. Services ran on time. Patients were kept informed of any disruption to their care or treatment.
  • The centre continually met patient’s needs through the way services were organised and delivered. Staff took account of the needs of different patients when planning and delivering services.
  • Staff always made reasonable adjustments and took action to remove barriers when patients find it hard to use or access services.
  • People knew how to complain or raise a concern. They were treated compassionately when they did so. There was openness and transparency in how complaints were dealt with. Complaints and concerns were always taken seriously, responded to in a timely way and listened to. Improvements were made to the quality of care as a result of complaints and concerns.

Well-led

Outstanding

Updated 16 October 2019

We rated well-led as Outstanding because:

  • The leadership team had the right skills, qualifications and experience to run a service providing high-quality care.

  • There was a clear vision of what the service wanted to achieve and plans to turn it into action. Staff in all areas knew and understood the vision, values and strategic goals.

  • There was continual engagement with patients, staff and the public.

  • The management team promoted a positive culture that supported and valued staff, creating a common purpose based on shared values.

  • There were governance processes to make sure that high standards of care were maintained.

  • There were systems to identify risks and action plans to eliminate or reduce them.

  • The service had secure electronic systems with security safeguards to protect confidential patient information.

  • There was a comprehensive process to identify, understand, monitor and address current and future risks. The service acted accordingly where issues were identified.

  • Candour, openness and honesty were the norm.

  • There was a culture of collective responsibility among all staff.

  • There were high levels of staff satisfaction. Staff were proud of the centre as a place to work and spoke highly of the culture.

  • There was a focus on continuous learning and improvement throughout the service. The service continually provided staff support. Staff had objectives focused on improvement and learning. Staff were encouraged to use information and regularly took time out to review performance and make improvements.

Checks on specific services

Surgery

Outstanding

Updated 16 October 2019

Surgery was the main activity of the service. We rated this service as outstanding because it was caring, responsive to people’s needs and well-led. We rated safe and effective as good.