We carried out an announced comprehensive inspection on 11 January 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Changes Clinic Limited is an aesthetic health and wellbeing clinic offering surgical and non-surgical treatments for face, hair and body for individuals over the age of 18.

Changes Clinic Limited is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of surgical procedures such as skin lesion removal and ear correction surgery. At Changes Clinic the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation. These included non-invasive fat reduction, Botox injections and semi-permanent makeup. Therefore we were only able to inspect the treatment for ear correction surgery and skin lesion removal but not the aesthetic cosmetic services.

Some services advertised by Changes Clinic Limited were undertaken by specialists who were not directly employed by Changes Clinic Limited. There was an agreement that these services would fall under the banner of Changes Clinic but would be provided by individuals who were renting out treatment space. For example the semi-permanent make up. The hair transplant services were undertaken by another organisation that had their own CQC registration. As such these areas were not included as part of this inspection.

The nominated individual of the clinic is also the registered manager. 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.

Client feedback was obtained through completed comment cards and speaking with clients during the inspection. Eleven people provided feedback about the service. All feedback was positive with comments about the professional yet friendly manner of staff and feeling fully involved in discussions about their care and treatment.

Our key findings were:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Not all staff had a record of having completed the training required by the clinic. However, the manager had plans in place for staff to attend training over the next few weeks and due to a small team prioritised by role and need.
• Policies and procedures were in place but not all of these had clear dates for review. Some policies were not formally documented such as the business continuity plan.

There were areas where the provider could make improvements and should:

• Review the existing arrangements for processes to follow in the event of an emergency which could affect business continuity.

• Review current methods for capturing and reviewing staff training to ensure all staff have completed relevant training required for their role. For example, infection control and information governance. Review the need to train all staff in safeguarding children.

• Review procedure for regular review of policies and procedures including for significant events and near misses.
• Review the need to have a risk assessment in place for staff without a DBS criminal records check.
• Consider a system to check clients identity when attending for treatments and consultations.