We carried out an announced comprehensive inspection on 14 November 2017 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 found two elements of notable practice namely:

• the provider had produced their own range of informative leaflets. These were very detailed. There were references in these leaflets to international research so that patients, who wished to become more involved, could access academic and technical material.
• There was a very wide range of lasers available allowing patients to be treated at the clinic rather than refering elsewhere.

Background

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 of the Health and Social Care Act 2008.

Dermatology Consulting:Skin, Laser and Cosmetic Clinic is a consultant lead dermatology service. It is located in detached premises in Royal Tunbridge Wells. It treats private patients. There is car parking on site. The staff comprise, a consultant dermatologist, seven nurses, administration, reception staff and cleaning staff.

The clinic is open during a range of hours including some evening and weekend opening. The hours are advertised on the service's website and answering machine.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. 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.

Therefore, at Dermatology Consulting: Skin, Laser and Cosmetic Clinic, we were only able to inspect the services which were subject to regulation.

The registered provider 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.

As part of our inspection we also asked for CQC comment cards to be completed by patients prior to our inspection. We received 56 comment cards all of which were very positive about the standard of care received. There was praise for the clinical staff, particularly for their diagnostic and listening skills. There was also praise for the reception staff for being caring and attentive.

Our key findings were:

• The care provided was safe. There was a culture of placing safety at the core of activity. Systems to support safe and safety within the building were effective and well embedded.
• The provider put the patients’ needs before other considerations with patients being advised that no treatment or a “wait and see” approach were the favoured options if that was clinically in the patients’ best interests.

• The was a strong emphasis on continuous learning for staff
• There was abundant information for patients on how to approach their treatment. This included providing in-house leaflets, as well as standard leaflets, and links to the latest dermatological research. Patients were enabled to be as knowledgeable about their choices as possible.
• There was a very wide range of lasers available allowing patients to be treated at the clinic rather than referring elsewhere.

We spoke with one person who used the service during our inspection and telephoned four other people to gain their views about it.

People said that they were very satisfied with the service. They said they had been provided with plenty of information about the treatments they were considering and the costs. Staff had taken time to explain what was involved and had asked them to sign consent forms.

A person said “I was given a full very through consultation and options to think about “and another said “When I got there, there was so much information”.

People confirmed they had received in depth consultations before they had any treatment and their information was updated each time they used the service.

People said staff were respectful, maintained their privacy and dignity and they felt confident treatments were given safely. People said “I always think it is a very nice environment and it is always clean”, “There is quiet efficiency going on, you feel it is very well run clinic” and “It is very professionally run, it is a welcoming environment and peaceful”.

We found that equipment was well maintained and that it had been checked and serviced when it needed to be.

Staff had been recruited using robust recruitment processes and were well trained for their roles.

People said they felt confident any concerns would be taken seriously and addressed.