We carried out an announced comprehensive inspection on the 7 February 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.

This service 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. At Dr Lynette Yong t/a Pure Age Management the aesthetic cosmetic treatments that are also provided are exempt by law from CQC regulation unless they are used to treat a medical condition. Therefore, we were only able to inspect the treatments covered by the CQC registration. At this service these included:-

• Bio-identical hormone replacement therapy, where medication prescribed was not available directly from a pharmacist,
• Intravenous IV nutritional therapy,
• Lipotherapy (Injection of lipolysis – not carried out at present)
• Botulinum toxin, when used for increased sweating.(not carried out at the time of inspection),

The treatments we did not inspect were:-

• Botulinum toxin and dermal fillers when used for cosmetic enhancement. (60% of work)
• Carboxytherapy
• Platelet rich plasma therapy
• Chemical peels
• Micro-dermabrasion
• Light treatment
• Micro medical skin needling
• Mesotherapy
• Microdermabrasion.

As part of our inspection, we reviewed 14 CQC comment cards completed by patients. They described the provider as caring, professional, patient focused and stated that they would recommend the service. Two patients stated in the CQC comment cards they were well informed about their treatments and that the doctor answered their questions. One stated that the doctor insisted that they have ‘minimal treatment for their needs’. Some commented they had attended the service for many years.

The provider had carried out a patient survey between May and June in 2017. Patients had completed 50 questionnaires where the provider asked the patient has to score each questions from one (poor) to five (excellent). When asked about the welcome/greeting they had received when they arrived at the clinic and all had stated a score of five.

Our key findings were:

• The practice had clear systems to keep patients safe and safeguarded from abuse.

• The provider had reliable systems in place to prevent and protect people from a healthcare-associated infection.

• The doctor wrote and managed the individual care records in a way that kept patients safe.

• The provider had arrangements in place to receive and comply with patient safety alerts, recalls and rapid response reports issued by the independent doctors federation.

• The provider was aware of their responsibility to notify CQC of all incidents that affect the health, safety, and welfare of people who use services.

• The provider assessed patients’ needs. This included their clinical needs and their mental and physical wellbeing.

• The provider advised patients what to do if their condition got worse and where to seek further help and support, such as the patient’s GP.

• The provider had an appraisal by the British College of Aesthetic medicine (BACM).

• The provider described how they encouraged patients to take part in the NHS screening procedures, such as breast and cervical screening.

• The practice obtained consent to care and treatment in line with legislation and guidance.

• Staff recognised the importance of patients’ dignity and respect.

• The provider had a complaints process in place. This included information about the steps patients could take if they were not satisfied with the findings or outcome once their complaint had been responded to.

• The provider understood the challenges to the service and what actions they had to take to address them.

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

Review the policy to include a risk assessment of whether staff who chaperone require a regular review of their DBS requirements.

We haven’t been able to speak to people using the service because there were no appointments booked at the time of this inspection. We gathered evidence of people’s experiences of the service by reviewing the satisfaction questionnaires returned to the service. We found that people who had used the service told us that they were given information about their care and treatment before they underwent procedures. They said that Dr Yong was "very professional".

Appropriate medical checks were undertaken before people received treatment including information on any medications they were taking.

People who use the service were given sufficient information and were involved in making decisions about their care. People who use the service reported Dr. Yong had understood their problem and that they understood their proposed treatment.

There was a safeguarding policy in place for protecting vulnerable adults, Dr Yong was able to describe what action she would take including contact the local authority.

Staff received adequate training and supervision. Dr Yong had a part time personal assistant that worked away from the location. We were told that there was a procedure in place for them to undergo annual appraisals where their performance would be discussed and targets set for the coming year. appraiser.

The service conducted audits to monitor the quality of the service it was providing. Regular patient feedback questionnaires were completed.

We were unable to speak to people who use services on this occasion however we saw the results of surveys from people that had used the service from January 2011-July 2011. All comments were postive about the service they had received