CJA Medical

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

Effective - This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence. We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

This is the first inspection for this service since its registration with CQC. This key question has been rated as Requires Improvement.

The service was in breach of legal regulation in relation to dignity and respect.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People were supported with their preferences for aesthetic treatment and given advice on the most safe and effective options available. Records we reviewed highlighted realistic treatment aims and outcomes, with holistic care planning such as advice on psychological wellbeing. The service had referral pathways to dermatologists for specialist advice and for privately funded treatments. Processes ensured suspected cancer assessments were urgently referred to people’s NHS GP.

During our review of clinical records, we noted staff checked people’s health, care, and wellbeing needs prior to treatment and follow up processes were used to assess outcomes. Clinical care plan templates when conducting reviews were used to support the assessment of health and wellbeing to document and inform treatment options and decisions. The service considered people’s medical history when planning care and treatment.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good service standards.

During our on-site visit, we reviewed a random sample of 5 clinical records and determined people’s care and treatment in relation to thread lifts was provided in line with evidence-based guidelines. Clinical notes were recorded to inform future care planning and were of good quality, including relevant safety-netting advice where required.

The service had an induction programme for clinical and non-clinical staff which included information for training, appraisal and guidance for providing evidence-based care. The service demonstrated an effective system for updating clinical guidelines and protocols. In particular, the service was SafeFace accredited (a Professional Standards Authority recognised, government-approved register for cosmetic practitioners) which shared the latest clinical research and updates to evidence-based guidelines to aesthetic procedures.

The service worked well across teams to support people, particularly when people moved between different services. Staff had access to the information they needed to appropriately assess, plan, and deliver care, treatment, and support.

There were processes to monitor and manage care when people moved between services such as after referrals to their NHS GP or following secondary care. The service held ‘daily huddles’ to review changes to treatment guidelines, learning from incidents, feedback or concerns and lone working arrangements, which involved all staff.

During our review of the service’s clinical records systems, we found examples of effective plans for the movement of people across services to inform future care and treatment planning, such as for further dermatological review. Clinical notes were managed appropriately and considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

From the records we reviewed during the on-site visit, we noted the service empowered and supported people to manage their own health, care and wellbeing needs by staff who understood their needs and preferences. For example, people who had undertaken cosmetic or aesthetic treatments were provided with information about their care, including safety netting advice, aftercare and follow-up guidance. People were encouraged to carry out some additional aftercare regimen at home where needed as part of their treatment plan and to improve outcomes.

The service did not always routinely monitor people’s care and treatment to continuously improve it. In particular, the service did not conduct any audits of its care and treatment to ensure it remained in line with best practice. This meant there were ineffective systems to monitor and improve treatment outcomes. However, from the records we reviewed, care was noted to be adequately followed up and assessed, such as documentation of outcomes pre and post treatment to meet clinical expectations and the expectations of people themselves. The service had independent verification of clinical treatments provided and a review of leaders’ professional qualifications. This helped to reduce the likelihood of complications due to leaders ensuring they had the experience required to carry out care and treatment effectively.

The service did not tell people about their rights around consent and did not have the processes in place to notify people’s rights when delivering care and treatment. The service did not have effective systems to ensure people’s informed consent was sought and respected in relation to the use of CCTV, resulting in a failure to protect people’s privacy, dignity and autonomy. During the on-site visit, the service was unable to provide evidence of a CCTV or data‑usage policy to explain the purpose of surveillance, the lawful basis for processing personal data, how consent would be sought or recorded, how long footage would be retained, or how people could exercise their rights under General Data Protection Regulations, including withdrawing consent. This meant there was no clear framework to support lawful, proportionate and consensual use of CCTV.

However, staff were trained on the requirements of mental capacity to inform safe and effective care. From the records we reviewed during the on-site visit, people’s views and wishes were considered when their care was planned and the service complied with the Mental Capacity Act 2005. Leaders understood the requirements of legislation when considering consent for treatment and decision-making.