We carried out an announced comprehensive inspection on 6 March 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.

The service provides medical treatment for a number of skin conditions, including eczema and psoriasis and minor surgery to remove cysts. 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. Brigstock Skin and Laser Centre also offers a range of aesthetic services not regulated by CQC including wart removal with liquid nitrogen, wrinkle reduction and laser hair removal.

The managing partner 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.

Twenty-two people provided feedback about the service, and the feedback was wholly positive.

Our key findings were:

• Risks to patients were assessed and well managed. We found only one issue: an expired medicine which had been replaced but had not been removed from the clinic supply.
• Audit was used to check care was delivered according to operating procedures.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There were arrangements to safeguard patients from abuse.
• Staff were allowed regular time for personal development, weekly meetings with the clinic manager to review their progress and annual appraisals.
• Patients said they were treated with compassion, dignity and respect.
• Information about how to complain was available and easy to understand, although the clinic did not always follow its complaints policy consistently (in sending acknowledgments).
• There was a clear leadership structure and staff felt supported by management.

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

• Review the significant events policy to consider clarifying the guidance on applying the Duty of Candour.
• Review the management of complaints to ensure the clinic policy is consistently applied.
• Review the risks associated with the decision to conduct a standard (rather than an enhanced) Disclosure and Barring Service check for non-clinical staff acting as chaperones.

The provider had procedures for providing information to people and obtaining consent prior to treatment. There were relevant policies and procedures in place to support staff in relation to consent. People had their treatment needs identified through an assessment which contributed to an individualised treatment plan. People we spoke with made positive comments about the service they had received, for example one person said that their treatment plan had been "tailor made" and another comment was that "they explained everything to me."

We saw that the premises were of a suitable design and layout and that a number of measures had been taken to ensure access to the building in line with legislation, for example, the Disability Discrimination Act 1995. We also found that the equipment used on site was properly maintained and was being used correctly. Staff were trained in the use the equipment.

The provider was able to show that appropriate contingency plans and procedures were in place for emergency situations.

We saw that there were appropriate recruitment procedures in place and that the employees were suitably qualified, skilled and experienced for the purposes of carrying on the regulated activity.

We spoke to one person who uses the service. They told us “the staff are really friendly, I am treated with dignity and my privacy is respected, staff explain my treatment to me and tell me how much the treatment costs, the centre is always clean and tidy”. They told us they had not seen a complaints procedure displayed at the centre however they had been provided with a patients guide and knew how to make a complaint if they needed to.