We carried out an announced comprehensive inspection on 9 August 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.

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.

Suffolk Medical Clinic Ltd is a medical skin laser and aesthetic clinic. They offer laser, hair and thread vein removal, dermal fillers, and Botulinum Toxin (Botox) treatments for cosmetic purposes, migraine pain, Bell’s Palsy (temporary facial paralysis) and Hyperhidrosis (excessive sweating).

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment of clients suffering with migraines, Bell’s Palsy and the treatment of Hyperhidrosis with the use of Botulinum Toxin. The treatment of clients with Botulinum Toxin was undertaken by a registered Doctor, who prescribes medicines, and a registered Nurse. The Doctor also provides a service for the removal of moles and sebaceous cysts via excision. At Suffolk Medical Clinic Ltd the aesthetic cosmetic treatments, including the use of laser treatment and dermal fillers, are exempt by law from CQC regulation and were therefore not inspected.

The service is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities:

• Treatment of disease, disorder or injury.

Suffolk Medical Clinic Ltd opened in 2000 and is run by a doctor and a registered nurse who is also 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 asked for CQC comment cards to be completed by clients prior to our inspection visit. We received 29 comment cards from clients who provided feedback about all aspects of the service. They were all very positive about the standard of care received. Comments included that the service provided expert advice and that the staff were polite, kind and caring.

Our key findings were:

• There was an effective system in place for reporting and recording significant events and these were monitored to completion. There was a process for sharing the learning within the service, when appropriate.
• The service had systems in place for the receiving of and acting on, safety alerts regarding the monitoring of medicines or devices.
• The service had several policies and procedures which were in place to govern activity.
• Risks to clients were assessed and well managed.
• There was an infection prevention and control policy and procedures were in place to reduce the risk and spread of infection.
• The service carried out fire drills and the fire equipment checks were up to date. The service had a fire safety policy and an appropriate fire risk assessment,
• Medicines were safely managed. There was evidence that checks had been undertaken, as there were records to demonstrate that medicines near to their expiry date had been ordered and supplied. Medicines were stored at the appropriate temperatures and daily checks were completed on medicines which needed cold storage.
• The service had good facilities and was well equipped to treat clients and meet their needs.
• The service provided an out-of-hours telephone service for clients with concerns post treatment and had a system in place to ensure a clinician was available in an emergency during holiday cover.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Clients said they were listened to, treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about the service and how to complain was available and easy to understand.
• There was an effective system for responding to and learning from complaints. The service had not received any complaints in the previous 12 months.
• The service was aware of and complied with the requirements of the Duty of Candour.
• Systems were in place to ensure that all client information was stored and kept confidential.
• There was a clear leadership structure and staff felt supported by management.
• The service proactively sought feedback from staff and clients, which it acted on.

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

• Embed the new induction process within the service.
• Ensure the safeguarding level three training booked for clinicians is completed in a timely manner.

Before people received any care or treatment they were routinely asked for their consent and the provider always recorded their wishes. One person told us, “The staff gave me lots of time to ask questions before I decided to go ahead with the treatment. I did not feel rushed.”

People experienced care, treatment and support that met their needs and protected their rights. People we spoke with were very positive about the service. One person said, “Staff communicate well with me and so I know when to expect some discomfort during the procedure."

People were cared for by suitably qualified, skilled and experienced staff. We saw evidence that staff had received appropriate training and held relevant qualifications.

A complaints procedure was available and outlined the service's responsibility to acknowledge complaints and feedback a final outcome. People told us that they would be confident in raising issues with the manager and trusted them to deal with any concerns swiftly.

Before people received any care or treatment they were routinely asked for their consent and the provider always recorded their wishes. All the care and treatment plans we looked at contained evidence of consent being obtained prior to people receiving treatment. One person told us, “Staff talked me through the procedure and any possible side effects. I signed a consent form and was happy that I understood the treatment.”

People experienced care, treatment and support that met their needs and protected their rights. People had thorough, detailed care and treatment plans relating to aspects of their care needs. People were very positive about the service. One person said, “Staff have been very reassuring and I have felt well supported throughout.”

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. The people we spoke with told us that they had no concerns with the cleanliness of the service.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. However there was scope to ensure that appropriate checks had been undertaken before staff began work.

A complaints procedure was available and outlined the service's responsibility to acknowledge their complaint and feedback a final outcome. People told us that if they had any concerns or complaints they were confident of using the complaints system.

Although we did not speak to any service users, the latest patient questionnaire showed that all 50 patients surveyed had rated their treatment and care as either Good or Excellent.