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Inspection carried out on 8 and 12 August 2019

During a routine inspection

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 carried out on 22/03/2017

During a routine inspection

Bella Vou Ltd is operated by Mr Amir Nakhdjevani. The clinic provides cosmetic surgery and outpatients services from 45-47 The Pantiles Tunbridge Wells. The clinic carries out a number of surgical procedures under local anaesthetic and has three operating theatres and outpatient and diagnostic facilities.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 22 March 2017.

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.

We found areas of excellent practice:

  • The service provided a high level of training for aesthetic plastic and reconstructive surgery via the post training fellows placement. It was most unusual for a service of this size to offer such a post and reflected the high regard that this service was held in by fellow plastic and reconstructive surgical specialists.

  • Staff worked especially hard to make the patient experience as pleasant and as individualised 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.

  • The service managed staffing effectively and services always had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.

Services we do not rate

We regulate cosmetic surgery services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following issues the service provider needs to improve:

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

  • The provider should review its serious incident reporting policy to include references relating to the duty of candour.

  • The provider should risk assess the placement of resuscitation equipment to cover all patient areas.

  • The provider should produce documented evidence when stock expiry dates are checked.

  • The provider should finalise its operational policy and share with the staff.

  • The provider should ensure that a debrief takes place at the end of all surgical procedures.

Professor Sir Mike Richards

Chief Inspector of Hospitals