We carried out an announced comprehensive inspection of OK Medical Limited TA Skin Doctor Leeds on 20 August 2018, to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led? We visited both their locations at Skin Doctors Leeds, 105 Otley Road, Headingly, Leeds LS6 3PX and Skin Doctors York, 66 Blossom Street, York YO24 1AP.

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.

The provider had previously been inspected at the Leeds clinic in February 2016 and at the York clinic in November 2017 and was found to be providing services in accordance with the relevant regulations across all key questions.

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.

OK Medical Limited TA Skin Doctor Leeds is situated in the Headingley area of Leeds, West Yorkshire. The provider also operates from a clinic situated at Skin Doctors York, 66 Blossom Street, York YO24 1AP. Clients can book an appointment at either clinic. OK Medical Limited TA Skin Doctor Leeds is a private skin care clinic and clients can access a range of skin and body treatments. The provider operates as a doctor-led service with support from aesthetic therapists and administrative staff.

There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. OK Medical Limited TA Skin Doctor provides a range of non-surgical cosmetic interventions, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services. This service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 to provide treatment of disease, disorder or injury and surgical procedures as regulated activites, therefore we did inspect against these.

One of the aesthetic therapists 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.

Our key findings were:

• The service was offered on a private, fee-paying basis only and was accessible to people who chose to use it.
• Procedures were safely managed and there were effective levels of client support and aftercare.
• There were systems and processes in place to safeguard clients from abuse.
• Information for service users was comprehensive and accessible.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• The service encouraged and valued feedback from service users.
• Communication between staff was effective.
• Client feedback was positive regarding the services. They commented on the caring attitude of staff and the cleanliness of the clinic.

There was an area where the provider could make improvements and should:

• Review and improve the mandatory training programme to ensure that all staff received training in basic life support.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection on 22 February 2016 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 services in accordance with the relevant regulations.

Are services effective?

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

Are services well-led?

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

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 associated with the Health and Social Care Act 2008.

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, including the prescribing of medicines for the suppport of cosmetic treatments. At Ok Medical Limited the cosmetic treatments that are also provided are exempt by law from CQC regulation.Therefore we were only able to inspect the treatment for certain areas of aesthetic cosmetic services.

OK Skin care is a private skin care clinic also known as Skin Doctors Clinics. This is a doctor led service. Patients can access a range of skin and body treatments including cryoliplysis (a treatment to reduce fat cells), hyperhidrosis (reduce excessive sweating) and botox and derma fillers. There are two independent doctors (who jointly own the practice) working at the practice with two salaried therapists and a receptionist.

The service provided appointments Monday to Saturday with evening appointments on a Tuesday, Wednesday and Thursday and Saturday opening 09:30 until 5pm.

The provider is also the lead clinician and the registered manager is the lead therapist. 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 viewed 12 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. In addition we spoke with patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice. They commented that staff were caring and respectful and that they had confidence in the service provided. Patients told us they had no difficulties in arranging a convenient appointment and that staff put them at ease and listened to their concerns.

We found the service had met the regulations and had in place robust systems and protocols for staff to follow which kept patients safe.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording incidents.
• Patients reported they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• All consultation rooms were well organised and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines and were led by a proactive management team.
• Risks to patients were well managed for example, there were effective systems in place to reduce the risk and spread of infection.
• Staff were kind, caring, competent and put patients at their ease.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.

There were areas where the provider could make an improvement and should:

• Formally risk assess how they would deal with medical emergency and consider CPR training for all staff.
• Review how auditing and risk assessments in areas such as Infection control audit and legionella. (Legionella is a germ found in the environment which can contaminate water systems in buildings).

At the previous inspection in September 2013 we found the provider to be non-compliant with four regulations of the HSCA 2008. These were cleanliness and infection control (Regulation 12); Safety and suitability of premises (Regulation 15,1, c); Supporting workers (regulation 23 1a,1b) and Assessing and monitoring the quality of service provision (Regulation 10 1a,1b,2a,2b(i)).

At this inspection we observed that people were cared for in a clean, hygienic environment. We confirmed there were systems in place to reduce the risk and spread of infection.

We found the premises were monitored regularly and appropriate checks had been undertaken to ensure patients and staff were protected from the risks of unsafe or unsuitable premises.

We saw evidence that staff received annual appraisals. They attended staff meetings and were supported to attend further and mandatory training where necessary. This meant patients were cared for by suitably qualified staff.

There were quality monitoring systems in place; which included patients giving feedback about their care and treatment. We saw evidence that feedback was acted upon appropriately.

We observed that people were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection.

There were quality monitoring programmes in place, which included people giving feedback about their care and support. This provided a good overview of the quality of the service’s provided.

People said they were fully involved in decisions about their treatments and the members of staff were very good at explaining the treatment they received. People told us they were given information about the treatment options and staff respected their decisions about which treatment they chose. Costs were also explained in detail. They told us they felt comfortable to ask questions about the treatments available.

We spoke with three people who told us they were happy with the care they received and no concerns were expressed about the treatment provided at the clinic. People we spoke with told us the clinic was clean, tidy and they had no concerns with the hygiene.

One person said, “Staff are brilliant, they explain what is happening”, “I am well looked after when I am here” and “I am asked to consent and there is a consent form for each treatment you have.” Another person told us, “It is a very friendly environment and I am well looked after”, “Everything is always explained and I know what’s going to happen,” and “The clinic is clean throughout but it is basic.”

We found evidence which identified some concerns with the clinics infection prevention and control processes and with the procedures for quality monitoring.

The person we spoke with about the services provided at the clinic commented that they were happy with their treatment and the professionalism of the staff.