Signature Clinic - Manchester Also known as Rochdale Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Our rating of effective stayed the same. We rated effective as good.

Staff assessed people’s health needs and worked well together and with service partners for the benefit of people who use the service. Most people experienced positive outcomes following their care and treatment. Staff provided information around healthier lives and supported people to make informed decisions about their care. They followed national guidance to gain consent from people who used the service.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People who used the service told us they underwent an initial consultation with a doctor prior to admission for surgery.

People told us the medical staff assessed their needs appropriately and took into account clinical needs as well as their preferences, such as choice of surgeon and preferred procedure date and location.

People told us the nursing and medical staff at the clinic reviewed and discussed their needs and preferences on the day of surgery and kept them up to date with their care and treatment.

Staff told us people received an initial consultation to identify their surgical needs and preferences and to determine if they were eligible for surgery at this clinic.

People undergoing surgical procedures were assessed on the day of surgery to assess their needs and to confirm their suitability for surgery. Staff told us patients were routinely reviewed as part of the aftercare process following their surgical procedure.

The service had policies and guidelines that provided guidance for staff around assessments required during initial consultations and following admission to the clinic on the day of surgery.

We looked at the care records for 7 people who used the service. The records included details of initial medical consultations and pre-operative assessments on the day of surgery. These included information such as contact details, clinical details, medical history, surgical history, social / lifestyle history and infection history.

The care records we looked at were complete and up to date. They included the surgical treatment plan for each person including prescribed medicines. Records showed staff carried out vital observations before, during and after surgery and completed individual risk assessments, such as for venous thromboembolism (VTE – blood clots) and took action to mitigate any risks identified.

People who used the service told us they felt staff were knowledgeable and their surgical procedures was carried out effectively. They told us staff carried out regular monitoring and observations and that they were provided with aftercare support following discharge from the clinic.

People told us the staff monitored any pain or discomfort during their surgical treatment and offered pain relief medicines if required.

People told us they were given clear advice on what to eat and drink prior to undergoing surgery and were offered beverages and snacks as soon as their procedure was completed.

The staff we spoke with had a good understanding of best practice standards for cosmetic surgery. They told us they followed surgical care pathways that were based on national guidelines.

Managers told us changes to clinical practice, national guidance and policies were reviewed and developed through routine monthly clinical governance and performance meetings and shared with staff.

Staff told us policies and procedures reflected current guidelines and were easily accessible in electronic and paper format.

Staff planned and delivered care and treatment according to best practice and national guidance, such as from The National Institute for Health and Care Excellence (NICE), the General Medical Council (GMC) professional standards for cosmetic surgery and Royal Colleges’ standards.

The national early warning system (NEWS2) was used to assess and respond to any change in a service user’s condition, in-line with NICE guidance CG50. Service users were risk assessed on admission for their risk of venous thromboembolism (VTE – blood clots), in line with the NICE guidance QS201. The theatre staff also used the ‘five steps to safer surgery’ checklists, based on World Health Organisation guidance.

The clinic used care pathways that had been developed to meet best practice guidelines. We reviewed care pathways for a number of surgical procedures, including blepharoplasty, gynecomastia and neck or face lift procedures and found these were based on best practice guidance.

We looked at a selection of the policies, procedures and care pathways and these were up to date and based on current national guidelines.

Care records showed staff used pain score tools, monitored people’s pain symptoms and prescribed pain relief medicines when required.

Staff gave people specific instructions around pre-operative fasting requirements where required, prior to undergoing surgery. People who used the service were provided with snacks and refreshments after their surgery.

People who used the service spoke positively about the way their care and treatment was coordinated from the initial consultation through to surgery and aftercare services. They told us the staff at the clinic worked well together as a team.

The clinic staff told us they worked well as a team. They told us they had a good relationship with the surgeons and regularly liaised with the administrative staff, initial consulting doctors and aftercare teams to plan and coordinate care and treatment.

Staff told us they held multidisciplinary team safety huddles twice daily to plan and coordinate care and treatment.

Staff told us they received good support from the provider-level pharmacist, governance and infection prevention and control teams.

We spoke with service partners who supported staff at the clinic and were based at the provider’s other locations (such as the governance leads, consulting doctors, group pharmacist and infection prevention and control nurse manager). They told us the clinic staff worked well as a team.

Service partners told us they routinely attended daily huddles and routine team meetings to discuss on-going risks and delivery of care and care and treatment.

We saw there was effective daily communication between multidisciplinary teams across the service. Staff safety huddles were carried out twice a day to ensure all staff had up-to-date information about risks and concerns.

Staff held regular and effective multidisciplinary meetings and daily safety huddles to discuss patients and improve their care. There were routine team meetings that involved staff from the different specialties.

The care records we looked at showed there was routine input from clinic staff, theatre teams, medical staff and pre-operative and aftercare teams.

People who used the service told us they received good support from staff and were provided with verbal and written information around healthier living. They told us they received routine advice and guidance from staff before and after their surgery.

Staff told us they routinely discussed health promotion and lifestyle choices with people who use the service as part of the initial booking and consultation process and as part of the aftercare advice following surgery.

This included advice on alcohol consumption and smoking cessation that was provided to help improve post-operative recovery following discharge from the clinic.

The service had a range of information leaflets promoting healthy lifestyles. This included information packs relating to smoking cessation, mobilising, hydration and alcohol consumption.

Care records showed people’s health needs were assessed as part of the initial consultation and discussed as part of the aftercare process following surgery.

The provider’s website included information and guidance around healthier living for people in relation to their surgical procedure.

We received a mixed response from people about their outcomes following care and treatment at this clinic.

During the on-site inspection, the 6 people we spoke with were positive about the quality of the care and treatment they received. They told us they were satisfied with the outcomes of their surgery.

During January 2024 to November 2024, we received negative feedback through our share your experience webform from 7 people who had used the service. The feedback was in relation to their concerns following surgery at the clinic during 2023/24. People reported they had complained to the service because they were not satisfied with the outcome of their surgical procedure. We also received positive feedback from 1 patient about the outcome of their surgery during this period.

Managers told us outcomes for people who used the service were monitored on a monthly basis and reviewed as part of the monthly clinical governance and performance meetings.

Managers told us the outcomes data collected included individual surgeon performance around procedures undertaken, complication rates, readmissions, surgical site infections, readmissions and return to theatres.

The service was not eligible for and did not participate in any national clinical audits.

Managers monitored the effectiveness of care and treatment and used findings to improve them. Meeting minutes showed outcomes data, such as complication rates, readmissions and site infections was collated and reviewed as part of monthly clinical governance and performance meetings.

The meeting minutes also showed the surgeon and overall clinic performance and outcomes data was benchmarked against the provider’s other locations nationally.

Records showed individual surgeon’s performance and outcomes was also reviewed and discussed as part of their annual clinical appraisals.

Outcomes for most people who use the service were positive, consistent and met expectations, such as national standards.

The overall complication rate following surgery at this clinic over the past 12 months was approximately 2.9%. This meant most people experienced positive outcomes following their cosmetic surgery.

The service reported 67 post-op complications in the past 12 months; of which 47 related to surgical site infections, 11 related to wound breakdowns and 6 related to post-op bleeds.

Records showed appropriate actions were taken following post-op complications, including readmission for corrective surgery for wounds complications and bleeds and antimicrobial medicines prescribed for post-op site infections. This was followed by after care follow up within 7 days to check if the additional treatment was effective and appropriate.

People who used the service told us they provided written consent prior to undergoing surgery and all the risks and benefits of the procedure were clearly explained to them verbally and in writing.

People told us the fees charged for treatments were clearly stated as part of their initial consultation and they were given a minimum 14 day ‘cooling off’ period from initial consent to day of surgery.

The staff we spoke with told us they had received training in and understood how to obtain informed verbal and written consent from people who used the service before providing any care or treatment. This included respecting people’s wishes if they refused treatment or withdrew their consent.

Managers told us if a person lacked capacity to make their own decisions (such as those living with a learning disability), then they would carry out an assessment as part of the initial consultation process to determine if they could admitted for treatment.

The provider’s consent policy provided guidance for staff around obtaining consent.

Services were only available to people over 18 years of age. People that were unable to give consent or had certain conditions, such as dementia or mental ill health were excluded for treatment at the service.

Staff clearly recorded consent in the peoples’ records and made sure people consented to treatment based on all the information available.

We looked at 7 consent records. They all showed that written consent had been obtained and the risks and benefits were documented and clearly explained to people who use the service.

Care records showed consent was undertaken as part of a two-stage process; firstly as part of the initial consultation and then repeated on the day of surgery. Records showed fees for surgical procedures were clearly explained as part of the initial consultation process.

Consent records showed there was a minimum 14 day cooling off period from time of initial consent to day of surgery, in line with Royal College of Surgeons’ guidelines. Staff also sought written consent from people to share images and the signed consent was documented in their care records.