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Inspection Summary


Overall summary & rating

Good

Updated 20 March 2020

Harley Health Village is operated by Linia Ltd. The service provides cosmetic surgery for privately funded patients over the age of 18 years of age.

The service is located in a multi-storey building, spread over the lower ground, ground floor and first floor. The service has six recovery beds on the ground and lower ground floors. The service has three admission and discharge rooms, which are also used for overnight stays. Facilities include two operating theatres, a consulting room, reception area and training/meeting rooms.

We last carried out an announced comprehensive inspection of the service in January 2017. At the last inspection, we did not have a legal duty to rate cosmetic surgery services when provided as a single specialty service.

We re-inspected this service using our comprehensive inspection methodology on 15 January 2020 in order to rate the service. Our inspection was announced, staff knew we were coming, to ensure that everyone we needed to talk to was available.

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

This was the first time we are rating this service. We rated the service as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients and acted on these assessments. The service kept detailed records of care and treatment. They managed medicines appropriately. Staff collected safety information and used it to improve the service. The service generally controlled infection risk well. Staff knew how to report patient safety incidents and could tell us about lessons learnt from them.

  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent to carry out their role. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Key services were available seven days a week.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their care. They provided emotional support to patients and those close to them.

  • The service planned care to meet individual patient’s needs and made it easy for people to give feedback. People could access the service when they needed it.

  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services.

  • Staff were overwhelmingly positive about the culture of the service. Staff were proud to work for the organisation and were committed to supporting their colleagues and meeting the needs of their patients. Managers promoted a positive culture where staff were valued and respected. Staff were supported and empowered by managers to raise concerns and suggestions for improvement.

However, we also found the following issues that the service provider needs to improve:

  • The risk register did not always highlight when the risks were last reviewed. Although we noted that the risk register was reviewed at the governance meeting. Following the inspection, the provider submitted an updated risk register which showed the issue had been addressed, and the updated risk register included the last review date.

  • Not all of the staff we spoke with were able to articulate some of the national and professional guidelines that influenced their practice.

  • We found an expired medicine and some out of date consumable items in the first aid box.

Following this inspection, we told the provider that they should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and the South East)

Inspection areas

Safe

Good

Updated 20 March 2020

This is the first time we have rated this service. We rated it as Good because:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
  • The service controlled infection risks well. The service used systems to identify and prevent surgical site infections. They kept equipment and the premises visibly clean.
  • The design, maintenance and use of facilities, premises and equipment kept people safe.
  • Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.
  • The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
  • The service used systems and processes to safely prescribe, administer, record and store medicines.
  • The service used monitoring results well to improve safety. Staff collected safety information and managers used this to improve the service.
  • The service managed safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.

However, we also found the following issue that the service provider needs to improve:

  • We found an expired medicine and some out of date consumable items in the first aid box.

Effective

Good

Updated 20 March 2020

This is the first time we have rated this service. We rated it as Good because:

  • The service provided care and treatment based on national guidance and evidence-based practice.

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

  • Staff assessed and monitored patients regularly to see if they were in pain, and gave pain relief in a timely way.

  • Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients.

  • The service made sure staff were competent for their roles.

  • From January 2019 to December 2019, the service reported 100% of all staff had received an appraisal.

  • Doctors, nurses and other healthcare professionals worked together as a team to benefit patients.

  • Staff gave patients practical support and advice to lead healthier lives.

  • Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

  • Staff always had access to up-to-date and accurate information on patients’ care and treatment. All staff had access to the patient’s record that they could all update.

However, we also found the following issue that the service provider needs to improve:

  • Not all staff we spoke with were able to articulate some of the national and professional guidelines that influenced their practice.

Caring

Good

Updated 20 March 2020

This is the first time we have rated this service. We rated it as Good because:

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

  • Staff provided emotional support to patients, families and carers to minimise their distress.

  • Staff supported and involved patients and those close to them in making decisions about their care and treatment.

Responsive

Good

Updated 20 March 2020

This is the first time we have rated this service. We rated it as Good because:

  • The service planned and provided care in a way that met the needs of patients it served.

  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.

  • People could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learnt with all staff.

Well-led

Good

Updated 20 March 2020

This is the first time we have rated this service. We rated it as Good because:

  • Leaders had the skills and abilities to run the service. They were visible and approachable in the service for patients and staff.

  • The service had a vision for what it wanted to achieve and a written strategy to turn it into action, developed with input from staff.

  • Staff were positive about the culture of the service. Staff were proud to work for the organisation and were committed to supporting their colleagues and meeting the needs of their patients. Managers promoted a positive culture where staff were valued and respected. Staff were supported and empowered by managers to raise concerns and suggestions for improvement.

  • Governance and performance management arrangements were proactively reviewed and reflected best practice. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

  • Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.

  • The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

  • The service engaged well with patients and staff to plan, manage and improve services.

  • The service was committed to continually learning and improving services.

However, we also found the following issue that the service provider needs to improve:

  • The risk register did not always highlight when the risks were last reviewed. Although we noted that the risk register was reviewed at the governance meeting. Following the inspection, the provider submitted an updated risk register which showed the issue had been addressed, and the updated risk register included the last review date.

Checks on specific services

Surgery

Good

Updated 20 March 2020

The service provided cosmetic surgical services for day case and inpatients together with related outpatient follow ups. We rated this service as good because it was safe, effective, caring, responsive and well-led.

The service had enough staff to care for patients and keep them safe. Staff treated patients with compassion and kindness, respected their privacy and dignity and took account of their individual needs.