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Inspection Summary


Overall summary & rating

Updated 3 May 2018

We carried out an announced comprehensive inspection on 17 April 2018 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 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.

My Beauty Doctor Ltd is a private, GP lead, dermatology service and provides aesthetic medical and cosmetic services in Marlow, Buckinghamshire. In addition, the service also undertook blood tests and reviews of the results of such tests for clients undertaking a specific weight loss programme.

My Beauty Doctor also conducts cosmetic treatments to day-clients using a range of non-invasive or minimally invasive procedures including laser and non-laser technology and treatment techniques.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Therefore, at My Beauty Doctor, we were only able to inspect the services which were subject to regulation. Specifically, we inspected the service relating to the blood tests and review of the results of such tests for clients undertaking a specific weight loss programme. The blood tests were carried out to monitor organ function during the rapid weight loss programme and were not available for those under the age of 18.

We received feedback from 17 clients about the service, including comment cards, all of which were very positive about the service and indicated that clients were treated with kindness and respect. Staff were described as helpful, caring, thorough and professional. However, there was no method to establish how many of the cards referred to the blood testing service we inspected.

Our key findings were:

  • The service had systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

  • Appropriate systems were in place to identify, assess and manage risk.

  • The service assessed needs and delivered the registered blood testing service in line with relevant and current evidence based guidance

  • Advice on maintaining healthy eating once the programme concluded was available to support a healthier life.

  • The service put their clients first before financial gain. They would not provide treatment where they felt it was not in the client’s best interest.

  • The provider was motivated to prioritise the needs of their clients and they would not provide treatment that they did not feel was in their best interest.

  • The service provided a range of appointments which allowed clients to access the blood testing service within an acceptable timescale.

  • Clients could contact the service or complete feedback forms in the suggestion box within the reception area, the service analysed this feedback including feedback on internet based review forums.

  • Governance arrangements ensured policies and procedures relevant to the management of the service were kept under review.

  • There was a commitment to widening the range of registered services available to people who wished to access private clinic services. For example, in May 2018 a new GP is joining the team which will lead to an increase in services provided.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Updated 3 May 2018

We found that the service was providing safe care in accordance with the relevant regulations.

  • There was a system in place for reporting and recording significant events. There had not been any significant events reported relevant to the regulated service so the process was untested in regard to the registered service. We saw events followed the system for the non-registered cosmetic services operated from the clinic and that learning from these events were shared with staff.

  • Staff had received safeguarding training and all staff had access to local authority information if safeguarding referrals were necessary.

  • There was no prescribing of medicines and no medicines were held on the premises with the exception of medicines to deal with a medical emergency. The service did not hold oxygen or an automated electronic defibrillator (AED). Formal risk assessments were completed every six months reviewing the potential for oxygen and an AED. We saw the risk assessments included an arrangement and details of the nearest supply of oxygen and AED.

  • We found equipment was visibly clean throughout the service, and staff had a good understanding of responsibilities in relation to cleaning and infection prevention and control.
  • The equipment in use that was relevant to the service inspected was maintained in accordance with manufacturer’s instructions.

Effective

Updated 3 May 2018

We found that the service was providing effective care in accordance with the relevant regulations.

  • There was evidence that the clinician working at the service at the time of inspection was aware of current evidence based guidance in following up blood test results. This included access to guidelines from the World Health Organisation (Drawing blood: best practices in phlebotomy).

  • There were limited systems to assess and monitor the quality of service that clients received. However, the element of service we inspected was in its infancy, less than 10 clients had commenced the programme. As a result there was little opportunity to draw comparisons with similar services.

  • The service had an induction programme in place for newly appointed staff, including the new GP who was starting in May 2018.

  • There was not a formal process for communicating with a client’s GP, although the GP contact details were requested on registration.

  • The nurse within the service had added an additional stage into the weight loss programme which enabled a further discussion to supporting clients whilst monitoring care. This was a telephone call at two week intervals; this included an informal discussion about maintaining well-being whilst completing the programme.

  • A written agreement was completed prior to commencing the weight loss programme and subsequent blood tests clearly identified regular blood tests would be required.
  • The service displayed full, clear and detailed information about the cost of consultations and treatments, including the cost of the weight loss programme that included the blood testing service. 

Caring

Updated 3 May 2018

We found that the service was providing caring services in accordance with the relevant regulations.

  • Clients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.

  • The initial medical assessment appointments were an hour long so all elements of care could be explained and there was sufficient time to answer client’s questions.

  • The service maintained a treatment decision approach that was ‘always in the best interest of the client’. Staff we spoke with demonstrated a person centred approach to their work.

  • Clients who completed Care Quality Commission comment cards said they received a compassionate service.
  • The provider maintained client information confidentiality.

Responsive

Updated 3 May 2018

We found that the service was providing responsive care in accordance with the relevant regulations.

  • Access to the service was on a planned pre-booked basis. Clients interested in taking up the service were given relevant information and booked their consultations as part of a planned programme.

  • The facilities and premises were appropriate for the service delivered.

  • The service was housed over two floors; regulated activities were provided on both floors accessed via stairs. The service was able to treat those with mobility restrictions who were unable to use stairs. However, clients were informed the premises were not accessible if they used a wheelchair or mobility aid.

  • The website for the service was very clear and easy to understand. In addition it contained clear information about the procedures offered.
  • Information about how to complain was readily available to clients.

Well-led

Updated 3 May 2018

We found that the service was providing well-led care in accordance with the relevant regulations.

  • Although a small team, there was a clear staffing structure and staff were aware of their own roles and responsibilities.

  • We received written feedback from members of staff which commented on the effective, supportive and inclusive leadership within the service.

  • Staff spoke of a commitment to help promote well-being, body image and confidence of clients attending the service.

  • The service had a range of appropriate policies and procedures to govern activity.

  • The provider submitted data or notifications to external organisations as required. For example, the service had recently notified and submitted an application to the Care Quality Commission to amend the registration of the service.

  • The service sought feedback from all clients attending blood test appointments. Feedback was consistently positive.

  • The service regularly monitored online comments and reviews and responded to these and they were shared in staff meetings. For example, the service had 12 reviews on WhatClinic with an average of 97% client satisfaction,
  • There was a commitment to widening the range of registered services available to people who wished to access private clinic services.