FKS Clinic

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed most risks. The facilities and equipment mostly met the needs of people. Some improvements were required to ensure that infection control processes minimised the risk of infection. The clinic was visibly clean and well-maintained. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff mostly managed medicines well and involved people in planning any changes.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a positive culture of safety, based on openness and honesty. We saw that complaints and feedback were used to improve services. Staff listened to concerns about safety and investigated incidents. However, there was currently no accident book to log any accidents that occurred. We were told, no accidents had occurred since the clinic opened. Team meetings were held to share information and feedback to staff to ensure that the learning was shared throughout the team. An example of this was how patient feedback was used to improve services.

The service encouraged patients to inform their general practitioners (GP) that they were self-funding a hair transplant. However, this was patients’ choice. The service asked patients for their GP details so that should they need other treatment the service could inform the GP. This occurred when the doctors at the service assessed that the patient needed other treatment to ensure that the hair transplant had the best outcome or if a post-surgical infection required further treatment. However, the patient was required to give consent to other agencies, such as their GP, being contacted.

The senior team had completed training in safeguarding practices. The nominated individual was trained to level three in safeguarding. Staff had access to a safeguarding module on the electronic training system, but most had not completed this at the time of the inspection. There was a poster on display for staff and patients which informed them of whom to contact should they identify a safeguarding concern. There had been no such concerns at the time of the inspection. The service took steps to ensure that children did not enter the service through advising parents not to bring children to the clinic.

The doctors met with potential patients through an online consultation. They discussed the patients desired outcomes for treatment and what could realistically be achieved. Where there were concerns regarding the effectiveness or the desired outcome being achieved, patients were asked to attend the clinic for a face-to-face assessment. Risks to the effectiveness of treatment were discussed with patients and where necessary further treatment sought from other agencies, such as their GP. Staff supported patients to achieve the outcomes that mattered to them.

The service did not always detect and control potential risks in the care environment. We reviewed the clinic's policies and spoke to staff. The policies did not give staff the guidance they needed when an incident occurred such as what to do in the event of a fire. Staff were not always clear what to do if a patient became unwell, despite having received basic life support training. The clinic had a resuscitation trolley which was fully stocked for this eventuality. However, the only algorithm for staff to follow if patients became unwell was how to treat anaphylaxis. In the event of an emergency the clinic staff would call the emergency services, and the doctors would commence cardiopulmonary resuscitation (CPR). Some staff struggled to understand the training packages provided without the use of a translations service. The procedure team did not use the WHO surgical safety checklist which enforces the scrutiny of routine tasks known to influence procedural efficiency and patient outcome. Staff checked to make sure equipment, facilities and technology supported the delivery of safe care. A daily walk around of the clinic was undertaken, by the practice manager, to highlight any issues and check lists to ensure that the service was safe were available within each procedure room.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff had all been recommended or known to the senior team. Whilst this meant that there was a good awareness of their skills and experience, the staff recruitment files were lacking documents such as interview notes, references, and vaccination status in case of cross infection issues. All staff had a recent Disclosure and Barring Service certificate. All staff completed a competency assessment which was planned to be re-evaluated annually. Some appraisals had been undertaken but this was an ongoing process and was yet to be formalised. A responsible Clinician had yet to be identified for those doctors who worked outside of the NHS. However the team had applied to join an association for hair transplant surgeons where wone would be available. Less experienced qualified staff had a mentor and supervisor. Staff worked together well to provide safe care that met people's individual needs.

We were told that infection rates were low. However, the service did not always assess or manage the risk of infection. We found that there were a number of areas where the infection prevention and control procedures could be improved to ensure the safety of the patient. There was no separate designated areas for clean and dirty instruments. Dirty non disposable instruments were washed in the hand washing sink and soaked with a cleaning solution before being collected by the contractor for sterilisation of these instruments. There was no safe storage option for these instruments whilst they awaited collection. Staff could not adequately explain how to wash their hands prior to working with a patient. Some staff also wore nail varnish which could reduce the efficacy of robust hand washing. The aprons used in a procedure were stored in the staff room potentially increasing the transmission of bacteria into the procedure room. The senior team had yet to commence an audit of complications such as patients’ infections. The service did not adequately provide for patients who may have a latex allergy.

The service did not always make sure that medicines and treatments were kept safe. The medicines cabinets were locked away but did not conform to BS2881:1989 in that they were glass fronted. Some medications which required cold storage were not stored within the medicine's fridge. However, the medicines fridge was monitored remotely, and an alarm would be given if this went out of the desired range. It was unclear if this had occurred. Staff involved people in planning their medication needs and advised them of any potential side effects. Patients were given medicines to take home with them when they left the clinic. Adjustments were made to routine take home medications based on an individual need.