We carried out an announced comprehensive inspection on 18 July 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 not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was not 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 not 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.

Bijoux Medi-Spa is registered with the Care Quality Commission to provide the regulated activities of Treatment of disease, disorder or injury and Diagnostic and Screening procedures. The address of the registered provider is 149 Ebury Street, London SW1W 9QN.

The Service Manager 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 asked for CQC comment cards to be completed by patients prior to our inspection. We received 48 comment cards which were wholly positive about the standard of care received at the service.

Our key findings were:

• There were limited systems in place to keep patients safeguarded from abuse. Information about who to contact with a concern was not accessible to staff. Not all staff had received training appropriate to their role.
• There was minimal evidence that risks were assessed and well-managed; the service did not have an effective system of health and safety and premises checks.
• Policies and procedures were generic and did not reflect day to day practice at the service. There was a lack of processes in place to ensure that policies and procedures were followed.
• The premises were clean and well maintained. There was an infection control audit, there were no follow up actions identified.
• Procedures for managing medical emergencies including access to emergency equipment were not safe.
• The clinic routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines. There was evidence of activity which aimed to improve the quality of clinical procedures provided.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients. Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was limited evidence of systems to support good governance and management.
• Staff felt involved and supported and worked well as a team.
• Patient feedback for the services offered was consistently positive.

We identified regulations that were not being met and the provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

You can see full details of the regulations not being met at the end of this report.

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

• Review the need for a policy to assess the service’s responsibility and liability for the supervision of the children of patients who bring children with them to the clinic.

We spoke to people using the service who told us that treatments were explained “in great detail”, including likely outcomes and side-effects. They said that the costs of treatments were “very clear”.

They described the service as “fantastic” and “brilliant”. They praised the quality of staff at the clinic and confirmed that they had been asked about their medical history prior to treatment taking place.

On the day of the inspection the practice was clean and tidy. People we spoke with described the clinic’s cleanliness as “spotless” and “very clean”.

Appropriate checks were undertaken before staff began work. These included checks on people’s identity, their right to work in the UK, their professional registration and a Criminal Records or Disclosure and Barring Service check.

There was a complaints policy and procedure in place. People that we spoke to said they would be happy to raise any concerns they had with staff.

People who use the service were not available to interview during our visit. There were questionnaires and other information that people had completed. These told us that people were satisfied with the service provided. They had the screening and diagnostic procedures fully explained during consultation and been made aware of alternative treatments available to them and any risks attached to them.

They did not directly comment on the clinic's quality assurance system but did tell us they were happy with the service they had received.