We carried out an announced comprehensive inspection on 12 November 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 care 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 of the Health and Social Care Act 2008.

Royal Tunbridge Well Skin Clinic is a doctor led dermatology service. It is in detached premises in Royal Tunbridge Wells. It treats private patients. There is car parking on site. The staff comprise, a doctor specialising in dermatology, an ascetic doctor, nursing staff, administration, reception staff and cleaning staff.

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

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 Royal Tunbridge Well Skin Clinic Ltd, 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 23 comment cards all of which were very positive about the standard of care received. There was praise for all the staff, from the helpfulness of those on reception to the communication skill of clinicians.

Our key findings were:

• The care provided was safe. There was a culture of placing safety at the core of activity. Staff told us they were encouraged to contribute to the organisation as a whole whether on safety or any other matters.

• 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 provider was technically innovative, adopting, after suitable research and trials, new medical and information technology.

• The was a strong emphasis on continuous learning for staff. The provider recognised consultation skills were central to patient’s care as well as satisfaction and had worked hard to maintain and improve this.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We were only able to speak with a limited number of people about the treatments they had received, and that were under the remit of the Care Quality Commission. However, the people we spoke with were positive about the treatment and service they had received.

There were information leaflets about a number of the treatments in the waiting area. There was more detailed information available in a clinic information book, which also included the cost of treatments. The people we spoke with told us that they had had the procedures they received explained to them. We saw that people had signed a consent form before they received treatment.

The interactions we saw between staff and people using the service were positive. The people we spoke with said the staff were generally very helpful, and were “always courteous and helpful” and another that they “go out of their way to put you at ease.”

People were invited to complete an electronic patient survey that was hosted on a website by an external company. The feedback was anonymised and mostly positive.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

We saw that routine servicing and testing had been carried out of equipment in the clinic which included the lasers, fire equipment and portable electrical equipment.

We were only able to speak to one person who was receiving treatment from the Royal Tunbridge Wells Skin & Laser Clinic as there were not many customers receiving treatments on this occasion under the registered activity and when they were in the clinic they were receiving treatment. One person we did speak with was entirely satisfied with the treatment they had received so far. They said the service was “efficient, reliable and friendly”.