We carried out an announced comprehensive inspection on 21 March 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 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.

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.

The Harley Street Clinic provides a private doctor consultation service for cosmetic surgery.

The clinic is open 8am to 8pm Monday to Friday and 8.30am to 6.30pm Saturday and Sunday.

The clinic hosts five cosmetic surgeons, several nursing staff and patient advisors. Pre and post-operative consultations and assessments take place in the clinic. Consultations for cosmetic surgery include breast augmentation, rhinoplasty, abdominoplasty, rhytidoplasty and blepharoplasty. Surgical procedures do not take place at the clinic but are provided at private hospitals in London.

The clinic is located over several floors in premises shared with another business. The reception and waiting area is on the ground floor; treatment rooms are at basement level and consulting rooms are located on the second and third floors.

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.

We do not regulate procedures that do not involve a cut to the body or if there is no equipment inserted. This includes procedures such as Botox, dermal fillers, chemical peels or laser hair removal.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. We received two comment cards which were both positive about the standard of care received. We spoke with six people on the day of inspection who also provided positive feedback about the service.

Our key findings were:

• Medicines were safely managed.
• There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members.
• The service had clearly defined and embedded systems, processes and practices in place to safeguard patients from abuse.
• The staffing levels were appropriate for the provision of care and treatment offered by the clinic with a good staff skill mix across the service.
• Risk management processes were in place to manage and prevent harm.
• The clinic had an infection control policy and procedures were in place to reduce the risk and spread of infection.
• Patient outcomes were reviewed as part of audits or quality improvement.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the clinic.
• The clinic shared relevant information with other services appropriately and in a timely way.
• Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
• Staff treated patients with dignity and respect.
• Patients were involved in decisions about their care and treatment.
• The service was offered on a private, fee-paying basis only and was accessible to people who chose to use it.
• The diverse staff group employed at the clinic meant translation services were available for patients for whom English was not a first language.
• The service offered flexible opening hours and appointments to meet the needs of their patients.
• There was a system in place which ensured a clear response to complaints with learning disseminated to staff about the event.
• The clinic had a governance framework that supported the delivery of quality care.
• There was a clear leadership structure and scheme of delegation in place.
• The service encouraged and valued feedback from patients, the public and staff.

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

• Review the suitability of using consulting rooms where patients are examined, but which do not have wash hand basins installed and staff rely on hand sanitiser gel dispensers.
• Remove or replace damaged patient examination couches to prevent cross infection between patients.
• Ensure that staff document whether patients are given a copy of the consent form.