We carried out an announced comprehensive inspection on 31 January 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

Notable practice;

The provider ensured that all patients had access to their follow-up service that was available at any time of the day or night immediately following a procedure for a period of 24 hours. This enabled patients to feel assured of immediate attention in the unlikely event of a complication following treatment, or if they felt concerned about something.

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 treatments such as hair removal, photo rejuvenation, radio frequency skin tightening and skin resurfacing. Minor surgical treatments include removal of skin lesions, cysts, and cosmetic procedures for eyelids.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner for minor surgical procedures. At Derby Skin Laser and Cosmetic clinic the aesthetic cosmetic treatments, including skin laser treatments that are also provided are exempt by law from CQC regulation. Therefore we were only able to inspect the treatment for patients/clients requiring minor surgical procedures but not the aesthetic cosmetic services.

The female 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.

16 people provided feedback about the service. All 16 patients were overwhelmingly positive about the service they had received. They told us that the staff were professional, polite, friendly, respectful and very thorough. Many patients said how pleased they were with the results of their treatment.

Our key findings were:

• The provider put their patients first before financial gain. They would not provide treatment where they felt it was not in the patient’s best interest.
• There was information available regarding treatments that were available.
• The clinicians made a thorough initial assessment, including discussing the patients’ relevant clinical history, prior to discussing treatment options available.
• Benefits and drawbacks of treatment options were discussed to assist patients in making decisions about their care and treatment.
• Written consent was obtained prior to the commencement of each treatment session.
• The treatment room for surgical procedures was maintained as a sterile environment similar to an operating theatre, where additional cleanliness and entry rules were observed and special footwear for use in sterile environments were used.
• The male partner was a Consultant Ophthalmic Surgeon at an NHS hospital and had received appropriate safeguarding training.
• There were limited amounts of medicines used by the service. These were mainly local anaesthetics, which were stored and checked appropriately.
• Sterile equipment was a mix of single use items and some which required sterilisation after use. The provider had an agreement with a local hospital for sterilisation of instruments. The packages we checked at inspection were all in date.
• Receptionists had received an induction when first recruited to the role and were aware of policies and procedures used in the clinic.
• Receptionists had not received a DBS check and there was no risk assessment made to mitigate against any risk. However, we were told that patients/clients rarely requested a chaperone.
• There were emergency medicines for use in case of anaphylactic reaction stored at the clinic which were accessible, however, there was no oxygen or defibrillator for use in an emergency and no risk assessment to justify this decision.
• Receptionists received an annual appraisal, and one clinican had received an appraisal through their NHS work, however, the clinican providing the majority of the treatments had not received an appraisal to check that competency had been maintained.

There was an area where the provider could make improvements and should:

• Consider holding emergency equipment such as a debibrillator and oxygen in the premises, or making a formal risk assessment to mitigate this risk.