We carried out an announced comprehensive inspection on 10 July 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 not 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.

Courthouse Clinics Body Limited Brentwood 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 for the purpose of weight loss blood monitoring and for Botox treatment for certain medical conditions. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At Courthouse Clinics Body Limited Brentwood, the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation. Therefore, we were only able to inspect services related to our regulation.

A senior manager is 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.

We received comments cards from people using the service. Six people provided feedback about the service. Feedback was positive regarding the services provided. Although some of this feedback may have related to services not regulated by CQC. One comment card contained positive feedback but also related to dissatisfaction with the way their complaint was handled.

Our key findings were:

• There were systems in place to safeguard people and their information.
• Information relating to patients was accurate and enabled staff to make appropriate treatment choices.
• There were systems in place to identify, assess and manage risk.
• The process for ensuring that patients were not under the age of 18 required strengthening.
• Patient feedback from the service’s satisfaction surveys were mostly positive.
• Although there were emergency medicines kept on site in case of anaphylactic shock, there was no oxygen available on site and no risk assessment to support this decision.
• There were systems in place relating to the taking of blood tests. We found the service received and acted upon the blood test results.
• There were systems in place to respond to incidents and complaints. Learning from incidents and complaints was shared.
• There was a clear leadership structure. Staff felt supported and had access to appropriate training.
• Governance arrangements ensured policies and procedures relevant to the management of the service were in place and kept under review, with the exception of those in relation to consent which required review in line with the latest changes in law around consent.

We identified regulations that were not being met and the provider must:

• Ensure care and treatment is provided in a safe way to patients.

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

• Review the consent policy with a view to the changes made in laws surrounding consent in 2017.
• Strengthen the procedures for carrying out identification checks to ensure treatment is not provided to patients under the age of 18 years.