Stratum Clinic

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at Stratum Clinic to follow up on concerns and breaches of regulation following our previous inspection in March 2023. The previous inspection led to a rating of requires improvement. At this inspection we identified some improvements had been made but there was a continued breach of regulation and governance processes were not sufficient, posing a risk to the health and welfare of patients. We will add full information about our regulatory response to the concerns we have described to a final version of this report, which we will publish in due course.

Stratum Clinic provides consultations and dermatological treatments for a variety of conditions including surgery for the treatment of skin cancers. They provide diagnostic tests and provide information and choices about potential treatments. Some medicines are prescribed by the service, where appropriate, which include treatment for acne. Some of the services are not regulated by the Care Quality Commission (CQC), such as cosmetic therapies. This report references only those services that are regulated by CQC.

There was no CQC registered manager in post but an application to add a new registered manager had been made. 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:

• The service did not always operate effective processes to ensure it provided safe care.
• Care was not monitored via appropriate systems of clinical audit.
• Clinicians were qualified and experienced in the areas of care they provided.
• There was insufficient monitoring of doctors’ training, background checks such as immunisations and their individual work.
• Record keeping for patient notes was not consistent with recording systems and policies. A new clinical record system had been introduced but was not being utilised as intended by doctors.
• There were arrangements to ensure consent was sought and that patients were fully informed about their care options.
• Reasonable adjustments were made to protect people’s privacy, dignity and enable access to the service where they had specific requirements.
• There were insufficient governance arrangements and lead roles were not defined properly. For example, the safeguarding and clinical governance lead was unsure of their responsibilities.
• There had been improvements to the monitoring and oversight non-clinical elements of the service. However, some processes were still not fully implemented or in line with national guidance.

The provider must:

• Operate systems and processes to ensure services are monitored, safe and effective as part of a system of good governance.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Healthcare