Archived: Harley Cosmetic Group

Updated 8 March 2022

Harley Cosmetic Group is located at 41 Harley Street, London W1G 8QH, and is a general dental and medical consultant-led provider of cosmetic services. We inspected the service in response to concerns received about the service.

Harley Cosmetic Group is operated by LXIR medical limited. The service opened in 2019. It is a private cosmetic and dental clinic in central London.

Harley Cosmetic Group, located at 41 Harley Street, London W1 8QH, was registered with the CQC in August 2019. The service is registered with the Care Quality Commission (CQC) for the regulated activities of treatment of disease disorder or injury, diagnostic and screening procedures and surgical procedures.

The registered manager was registered in August 2019. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 service is located within rented premises, on the fourth floor of 41 Harley Street, London W1 8QH. The Harley Cosmetic Group offers both dental and cosmetic services from these premises. The service has access to one consultation room which also serves as an administrative office. There is a dental surgery and a cosmetic theatre on the fourth floor.

All clinics at 41 Harley Street, London, W1 8QH operate as independent businesses, on a sub-let tenancy, with their own opening times and business hours. As part of a tenancy contract, the service has access to a receptionist on the ground floor, a waiting area, toilets and a lift from the ground floor to the fourth floor.

Updated 8 March 2022

Harley Cosmetic Group is operated by LXIR Medical Ltd. It is a private cosmetic and dental clinic in central London. The cosmetic service is a consultant-led provider of cosmetic services. There is one consultant working for the service. No surgical procedures requiring general anaesthetic are undertaken at the location. Patients requiring general anaesthetic surgery are referred to an independent private clinic in Harley Street, London.

Patients at Harley Cosmetic Group are seen for a full range of dental procedures and pre- and post-operation cosmetic consultations, for example, liposuction, (this is a type of fat-removal procedure). Patients can self-refer or are referred from the Harley Body Clinic referral website. All procedures are performed by the Harley Cosmetic Group.

The cosmetic service operates from Monday to Friday, with occasional Saturday clinics. The dental service operates on Monday and Thursday. However, at the time of this inspection the service was suspended following CQC’s inspection on 1-3 December 2021.

The main service provided by this service is cosmetic procedures and dental services. There was one registered manager for both cosmetic procedures and dental services.

The service primarily serves the communities of the London area. It also accepts patient referrals from outside this area. The provider is registered for the regulated activities: treatment of disease, disorder or injury, surgical procedures and diagnostic and screening procedures.

This was a follow up inspection to investigate whether concerns from our previous inspection on 1 and 3 December 2021 had been resolved.

We rated Harley Cosmetic Group as inadequate overall because:

• During a previous inspection we found the service did not have a clear escalation pathway for deteriorating patients. During this inspection the service still did not have a clear escalation pathway for a deteriorating patient which was tailored to the service.
• The service did not have eligibility criteria which defined if patients were suitable for cosmetic surgery.
• Clinical staff did not have up to date training in basic life support (BLS).
• Equipment was not serviced in accordance with servicing schedules and manufacturers’ instructions. We saw a range of equipment which was out of date, including resuscitation equipment, for example, a defibrillator which had not been serviced since 2019.
• The service did not have a tailored, documented pathway for patients’ journeys through treatment including assessment, planning, implementation and review.
• At our previous inspection, we found the service did not ensure medicines were safely stored. During this inspection we found the service still did not ensure medicines were stored safely.
• At our previous inspection we found there was no system of medicines audit or stock control. During this inspection we found there was still no system of medicines audit or stock control.
• The service did not have clear procedures relating to the management of clinical waste including medicines.
• We found a sharps bin in the consultation room which was not signed and dated.
• The registered manager’s level 3 safeguarding training was completed in 2018 and had not been updated in accordance with intercollegiate guidance which states level 3 refresher training should be updated every three years.
• During our previous inspection we requested to see all patient records and were not provided with evidence of full individual patient care records including risk assessments. During our previous inspection patients’ records were not stored securely. We were told that patient records were being held at a person’s house who was not employed by the service. During this inspection we were told patients records were still being stored at a person’s house who was not employed by the service.
• The service did not have a system in place to review medicines order forms and copies of patient prescriptions.
• Policies were not tailored to the service being provided. The service did not have an infection prevention and control lead, in accordance with the service’s policy.
• The service did not have any cleaning schedules or records of cleaning, including theatre deep cleans.
• The service could not produce, when requested, a waste disposal contract which included arrangements for the disposal of medicines.
• Staff did not have full pre-employment checks. Staff did not have references or photographic proof of identify or eligibility to work in the UK.
• There was no evidence, when requested, that one member of staff had applied for a Disclosure and Barring Service (DBS) check.
• The service was unable to produce evidence of a staff training schedules, including frequency of training updates. The service was unable to produce evidence of staff having completed training in Sepsis awareness when requested.
• The service did not audit the use of the World Health Organization (WHO) ‘Steps to Safer Surgery’ checklist.
• Risk assessments for the clinical areas of the service were not robust and training relating to the risk assessments had not been completed by any staff.
• The service did not have any systems of clinical audit. Risk management systems were not robust.
• The registered manager did not demonstrate an understanding of the obligations placed on them by their role as registered manager or the fundamental standards of care.

As a result of this inspection, we took urgent action to extend the suspension of registration of the provider for a period of ten weeks. We told the provider they must take actions to comply with the regulations and that it should make other improvement. These can be found at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals

Updated 8 March 2022

We rated the service as inadequate because:

• The service did not have a clear escalation pathway for deteriorating patients.
• The service did not have eligibility criteria which defined if patients were suitable for treatment.
• Clinical staff did not have up to date training in basic life support (BLS).
• Equipment was not serviced in accordance with servicing schedules and manufacturers’ instructions.
• The service did not have a tailored documented pathway for patients’ journeys through treatment including assessment, planning, implementation and review.
• The service did not ensure medicines were safely stored.
• There was no system of medicines audit or stock control.
• The service did not have clear policies relating to the management of clinical waste including medicines.
• The registered manager’s level 3 safeguarding training was not updated in accordance with intercollegiate guidance.
• Patient records were not stored securely. We were told that patient records were being held at a person’s house who was not employed by the service.
• Policies were not tailored to the service being provided.
• The service did not have any cleaning schedules or records of cleaning, including theatre deep cleans.
• All staff did not have full pre-employment checks including Disclosure and Barring Service (DBS) checks.
• The service was unable to produce evidence of a staff training schedules, including frequency of training updates.
• The service did not audit the use of the world health organization (WHO) ‘Steps to Safer Surgery’ checklist.
• Risk assessments for the clinical areas of the service were not robust and training relating to the risk assessments had not been completed by any staff.
• The service did not have any systems of clinical audit. Risk management systems were not robust.