• Doctor
  • Independent doctor

Brighton Skin Surgery

Overall: Good read more about inspection ratings

Mile Oak Medical Centre, Chalky Road, Brighton, East Sussex, BN41 2WF (01273) 776600

Provided and run by:
Dr. Avni Patel

All Inspections

14 July 2023

During an inspection looking at part of the service

This service is rated as Good overall .

The key questions are rated as:

Are services safe? - Good

Are services effective? - Good (carried over from previous inspection)

Are services caring? - Good (carried over from previous inspection)

Are services responsive? - Good (carried over from previous inspection)

Are services well-led? - Good (carried over from previous inspection)

We carried out an announced comprehensive inspection of Brighton Skin Surgery on 17 June 2022. We identified breaches of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and issued a requirement notice. The service was rated as requires improvement for providing safe services. It was rated as good overall and good for providing effective, caring, responsive and well led services.

We carried out this inspection of Brighton Skin Surgery on 14 July 2023, to confirm that the service now met the legal requirements in relation to those breaches of regulation and to ensure sufficient improvements had been made. As a result of this inspection, the service is now rated as good for providing safe services. Our ratings of good for effective, caring, responsive and well led services are carried over from the previous inspection.

We carried out an announced visit to the service on 14 July 2023. We spoke to staff and reviewed documentary evidence during our site visit.

Brighton Skin Surgery provides an independent, doctor-led dermatology, minor surgery service. Procedures offered include skin tag, cyst, mole, wart and cherry or blood spot removal.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of all of the services it provides.

Brighton Skin Surgery is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury, Diagnostic and screening procedures and Surgical procedures.

The medical director 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.

We found that the service had made improvements since our previous inspection and was compliant with the requirement notice. In particular:

  • The provider had developed monitoring processes to fully assure themselves that the premises they were leasing were safe and that health and safety requirements were met.
  • Risks associated with Legionella, electrical and fire safety arrangements within the premises were appropriately assessed and managed.
  • Appropriate records were held relating to staff immunisations, in line with current guidance.

The areas where the provider had made other improvements were:

  • Information was provided for patients on the service's website about how to make a complaint.
  • Policies were monitored to ensure their timely review.

The areas where the provider should make improvements are:

  • Develop processes to record assurance checks undertaken to review health and safety monitoring arrangements.

Dr Sean O'Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care

17 June 2022

During a routine inspection

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of Brighton Skin Surgery on 17 June 2022 under Section 60 of the Health and Social Care Act 2008. 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. This was the first rated inspection of the service. The service was previously inspected in December 2017, when it was found that the service did not always provide well-led services and a breach of regulation was identified. We carried out a follow up inspection in March 2018 and the service was found to be meeting all regulations.

Throughout the COVID-19 pandemic the Care Quality Commission (CQC) has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Speaking with staff in person and using video conferencing.

• Requesting documentary evidence from the provider.

• A site visit.

We carried out an announced site visit to the service on 17 June 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff using video conferencing prior to our site visit.

Brighton Skin Surgery provides an independent, doctor-led dermatology minor surgery service.

Procedures offered include skin tag, cyst, mole, wart and cherry or blood spot removal. The service is based within a local NHS GP practice, Mile Oak Medical Centre, on the outskirts of the city of Brighton and Hove.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of all of the services it provides.

Brighton Skin Surgery is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury, Diagnostic and screening procedures and Surgical procedures.

The medical director 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.

Our key findings were:

  • There were safeguarding systems and processes to keep people safe.
  • Arrangements for chaperoning were effectively managed. Staff had received chaperone training and had been subject to Disclosure and Barring Service checks.
  • There were effective systems and processes to assess the risk of, and prevent, detect and control the spread of infection. There were processes for auditing of infection prevention control arrangements.
  • The monitoring of staff immunisations did not always reflect current guidance.
  • There were appropriate arrangements to manage medical emergencies and suitable emergency medicines and equipment in place.
  • There had been insufficient action taken to identify and address some legionella, fire safety and health and safety risks which were managed by the host GP practice.
  • Clinical record keeping was clear, comprehensive and complete.
  • There was evidence of clinical audit, monitoring of patient treatment outcomes and regular auditing of clinical record keeping processes.
  • Best practice guidance was followed in providing treatment to patients. For example, excised lesions were routinely sent for histological review.
  • There were clear and effective clinical governance and monitoring processes. However, the provider had not sought sufficient assurances that the premises they were leasing were safe and appropriately managed.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Provide information for patients on the service’s website about how to make a complaint.
  • Monitor policies to ensure their timely review.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

20 March 2018

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Brighton Skin Surgery on 8 December 2017. We found that the service was providing safe, effective, caring and responsive services. However, we found that the service did not always provide well-led services and a breach of regulation was identified. The full comprehensive report on the inspection can be found by selecting the ‘all reports’ link for Brighton Skin Surgery on our website at www.cqc.org.uk

Specifically, we said they must:

  • Ensure systems and processes are in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk which arise from the carrying on of the regulated activity.

After the previous inspection on 8 December 2017, the provider wrote to us to say what they would do to meet legal requirements. We undertook this focused inspection on 20 March 2018 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

Our key findings for this inspection were as follows:

  • There were processes in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users.
  • Medicines were stored safely.
  • Systems were in place to deal with medical emergencies and the provider had appropriate emergency medicines in place.

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.

Brighton Skin Surgery provides a minor surgery service for dermatology. Procedures offered include skin tag, cyst, mole, wart and cherry or blood spot removal. The service is based in a local NHS GP surgery on the outskirts of the city of Brighton and Hove.

Dr. Avni Patel 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.

8 December 2017

During a routine inspection

We carried out an announced comprehensive inspection at Brighton Skin Surgery on 8 December 2017 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 not always 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.

Brighton Skin Surgery provides a minor surgery service in dermatology. Procedures offered include skin tag, cyst, mole, wart and cherry or blood spot removal. The service is based in a local NHS GP surgery on the outskirts of the city of Brighton and Hove.

Dr. Avni Patel 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.

Nine people provided feedback about the service via comment cards all of which were positive about the standard of care they received. The service was described as excellent, professional, helpful and caring.

Our key findings were:

  • The clinic was supported by services provided by a GP practice on the same site including practice policies, protocols and non-clinical governance.
  • The approach to safety of systems for reporting and recording incidents was in place. However, these systems were not always adhered to.
  • Information about services and how to complain was available and easy to understand.
  • The surgery room was well organised and equipped, with good light and ventilation.
  • The provider assessed patients according to appropriate guidance and standards.
  • Staff maintained the necessary skills and competence to support the needs of patients. Staff were up to date with current guidelines.
  • Risks to patients were well managed. For example, there were effective systems in place to reduce the risk and spread of infection.
  • Medicines were not always stored safely.
  • Systems were in place to deal with medical emergencies, staff were trained in basic life support and the provider had appropriate emergency medicines in place. However these medicines were not checked in accordance with the provider’s policy and some had expired.
  • Staff were kind, caring and put patients at their ease.
  • Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
  • The provider had a clear vision to provide a high quality service that put caring and patient safety at its heart.
  • The provider was aware of, and complied with, the requirements of the Duty of Candour.

We identified regulations that were not being met and the provider must:

  • Ensure systems and processes are in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk which arise from the carrying on of the regulated activity.

You can see full details of the regulations not being met at the end of this report.

6 December 2013

During a routine inspection

People were complimentary about the care and treatment they had received. The provider gave people enough information in order for them to make decisions about their treatment. The provider follows a robust consent procedure with patients signing written consent forms before commencing treatment.

People told us that they were extremely happy with their treatment and the professionalism of the provider. People had their individual needs assessed before commencing treatment and were given detailed information, including risks and benefits. We found that the general atmosphere of the surgery was warm and welcoming.

We looked around the premises and saw that it was safe, accessible, comfortable and clean. The treatment room was well equipped and maintained people's dignity and privacy. There were contingency plans in place for emergency situations.

The provider had the appropriate qualifications, skills and knowledge to undertake her role, supported by on-going professional development. Testimonials of people who had used the service commented on the provider's expertise such as, "The doctor provided an excellent service and was careful and competent".

The provider had effective systems in place to monitor the quality of service provision through audits and feedback. The provider had an awareness of how to deal with incidents, risks and complaints. People using the service felt confident to discuss any concerns with the provider.

20, 21 March 2013

During a routine inspection

During our inspection we spoke with the provider and a member of staff at the surgery. We also spoke with people who used the service and reviewed records, policies and cleaning schedules.

People were happy with the care that they received and told us, 'I felt reassured all through my treatment. I would recommend the service'. We saw testimonials of people who had used the service where people had made comments such as, 'I was delighted with my treatment' and 'It was a quick and friendly service'.

People were given leaflets with information about their conditions and what the surgery provided. The provider also had a website with contact details and information about the prices for different procedures.

We looked at the room that was used for the surgery. We saw that it was clean and had adequate washing facilities. There were arrangements in place to ensure that the room was kept clean and free from infection.