Archived: Prem House Clinic Ltd

Updated 20 December 2018

Prem House Clinic Ltd is operated by Prem House Clinic Ltd. The service is a private clinic based in Liverpool, Merseyside. The clinic provides cosmetic surgery services for private fee-paying adult patients over the age of 18 years.

The hospital has had a registered manager in post since February 2018. At the time of the inspection, a new manager had also recently been appointed and was registered with the CQC in October 2018. This meant there were two registered managers for this service with shared responsibilities at the time of the inspection.

There were no special reviews or investigations of the service ongoing by the CQC at any time during the 12 months before this inspection. We previously carried out a comprehensive inspection of this service in July 2016 and identified regulatory breaches in relation to staffing, good governance, and safe care and treatment. We issued a warning notice to the provider following that inspection. We carried out a follow up inspection in July 2017 to check whether improvements had been made. We found that the service was meeting all standards of quality and safety it was inspected against during the follow up inspection.

The clinic is registered to provide the following regulated activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury

Updated 20 December 2018

Prem House Clinic Ltd is operated by Prem House Clinic Ltd. The clinic provides cosmetic surgery services for private fee-paying adult patients over the age of 18 years. Most patients are admitted for planned day case surgery procedures but can be accommodated overnight if required. Facilities include four consultation rooms, a ward with seven beds and one operating theatre.

The main service provided by the clinic is surgery. We inspected this service using our comprehensive inspection methodology on 30 October 2018.

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 is the first time we have rated this service. We rated it as Good overall.

We found the following areas of good practice:

• Staff recognised incidents and reported them appropriately. The service had suitable premises and equipment and looked after them well.
• The service provided care and treatment based on national guidance and evidence of its effectiveness.
• Staff cared for patients with compassion. Feedback from patients confirmed staff treated them well, and with kindness. Staff provided emotional support to patients to minimise their distress.
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff had training on how to recognise and report abuse and they knew how to apply the required actions.
• The service made sure staff were competent for their roles. Doctors, nurses and other healthcare professionals supported each other to provide good care.
• Staff sought consent from patients prior to delivering care and treatment. The service took account of patients’ individual needs.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
• Managers promoted a positive culture and had the right skills and abilities to run a service providing high-quality sustainable care.
• There was a clear vision for the service and the mission statement and philosophy of care had been shared with and was understood by staff across the service.
• The service had effective governance systems and processes for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

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

• The incident log summary record used for identifying themes and trends was not fully complete and kept up to date.
• The risk register record had not been kept up to date.
• The service did not have a formal strategy document in place.
• The clinic did not store emergency bloods; however there was an arrangement with a neighbouring NHS acute trust for the supply of emergency blood if needed.
• The named safeguarding lead was not trained to level 4 safeguarding training, in accordance with the intercollegiate document; AdultSafeguarding: Roles and Competencies for Health Care Staff (August 2018).

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

Ellen Armistead

Deputy Chief Inspector of Hospitals (North Region)

Updated 20 December 2018

Surgery was the main activity of this service.

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