H.B. Health Limited

This service is not rated in this inspection as no regulated activities were being provided. We carried out an announced comprehensive inspection at H.B. Health Limited, to follow up on breaches of regulations.

HB Health Ltd is a private clinic providing a range of anti-ageing and aesthetic treatments using medicines, treatments and anti-ageing technologies.

There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. HB Health Ltd provides a range of non-surgical cosmetic interventions, for example, dermal fillers, non-surgical nose reshaping, skin lifting and tightening and gynaecological treatments using a laser which are not within CQC scope of registration. Therefore, as the service was not carrying out any regulated activities as outlined in the provider’s Statement of Purpose, we have not been able to rate the service. We have asked the provider to send us an updated Statement of Purpose as a matter of urgency. It is an offence under Care Quality Commission (Registration) Regulations 2009: Regulation 12, which states that providers must notify CQC of any changes to their statement of purpose and ensure it is kept under review.

CQC inspected the service on 18 December 2018 (also unrated) when regulated activities were being provided. We asked the provider to make improvements to address the following; the provider was not ensuring governance arrangements were operated effectively to assess, monitor and improve the quality of services; to assess, monitor and mitigate risks relating to the service and to evaluate and improve the service. This included a lack of infection control audits and COSHH data sheets. Furthermore, the registered person had failed to take such action as is necessary to ensure that persons employed continued to have the qualifications, competence, skills and experience necessary for the work to be performed by them. In particular, not all staff had completed training in safeguarding, infection control and fire; staff records held on site were incomplete. At this inspection regulated activities were being provided.

We checked these areas as part of this comprehensive inspection and found these had not been resolved. We have highlighted below where the provided should make improvements before carrying out any regulated activities in the future.

We received feedback from five people 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, organised and professional.

Our key findings were:

• Systems and processes were not always in place to keep people safe. The service had not had a registered manager since April 2018. This is in breach of the provider’s conditions of registration with the Care Quality Commission and is an offence under Section 33 of the Health and Social Care Act 2008. 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.
• The clinic manager was the lead for safeguarding but neither they or the administration staff had completed their safeguarding training.
• The provider was aware of current evidence-based guidance and they had the skills, knowledge and experience to carry out his role.
• The provider was aware of their responsibility to respect people’s diversity and human rights.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a complaints procedure in place and information on how to complain was readily available.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The service had systems in place to collect and analyse feedback from patients.

The areas where the provider must make improvements before carrying out any regulated activities are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements before carrying out any regulated activities are:

• Develop guidance and undertake a risk assessment for which emergency medicines are needed against the current guidance.
• Develop effective infection control measures to govern activities such as; Cleaning schedules, the recommended storage of cleaning equipment such as mops and introduce a spillage kit for the cleaning of bodily fluid spills.
• Establish a quality improvement plan that will show how you will demonstrate improved outcomes for patients.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care