We carried out an announced comprehensive inspection on 18th December 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 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.

HB Health Ltd is a private clinic providing a range of anti-ageing and aesthetic treatments using medicines, treatments and anti-ageing technologies. Clients can access therapists and doctors for advice, consultation and diagnosis, external and internal treatments and medications as required. The clinic is located near Knightsbridge and South Kensington underground stations.

The service is in the process of registering a 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.

We received feedback from 13 people about the service, including comment cards, all of which were very positive about the service and indicated that clients were treated with kindness and respect. Staff were described as helpful, caring, thorough and professional.

Our key findings were:

• Systems and processes were not always in place to keep people safe. The registered manager was the lead member of staff for safeguarding and was booked for adult and child safeguarding training the day after this inspection was undertaken. Not all of the administration staff had completed their safeguarding training.
• The provider was aware of current evidence based guidance and they had the skills, knowledge and experience to carry out his role.
• The provider was aware of their responsibility to respect people’s diversity and human rights.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a complaints procedure in place and information on how to complain was readily available.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The service had systems in place to collect and analyse feedback from patients.

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

• Introduce a programme of Infection control audits
• Ensure that all staff do all the mandatory training (as per your policy) this should include Infection control, consent, fire training and the appointment of a trained in-house fire warden
• Ensure that staff records for all staff include training records, appraisals, revalidation and medical indemnity.

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 chemicals held on site and ensure that you have Control of Substances Hazardous to Health (COSHH) data sheets for them.
• Review which emergency medicines were needed and risk asses them against the current guidance.
• Review information provided to patients and ensure that in contains information on how to complain.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

At our last inspection on 06 May 2014 the provider was unable to demonstrate that all staff had been recruited safely and had an adequate understanding of safeguarding vulnerable adults.

At this inspection on 29 May 2014 we found the provider was able to demonstrate that they had implemented a safe recruitment process and that all staff were suitably knowledgeable and understood how to identify and report adult safeguarding concerns.

In response to our previous inspection on 25 September 2013 the provider had made some progress in addressing the concerns identified. However, we found continuing non-compliance with the regulations for safeguarding people who used the service and requirements relating to workers.

The provider had not ensured that all staff were suitably knowledgeable and understood how to identify and report adult safeguarding concerns. The provider did not provide requested information to demonstrate that staff had been recruited safely.

However, the provider was now compliant with the regulations relating to assessing and monitoring the quality of service provision. The provider had introduced a patient questionnaire to enable them to gather their views as part of their quality assurance process.

The three people we spoke to on our visit were very satisfied with the treatment they received from HB Health. One person said 'The staff here are lovely. Very courteous. It's a very good service; calm and unhurried.' Another said that the staff were very professional and everyone was well informed. They were all satisfied with the treatment they received from the service.

We saw that there was sufficient information provided to people about their treatment and people were given information about the relative risks and benefits of the procedures available. This enabled them to make informed choices about their treatments.

The provider had a policy on safeguarding; however some staff were not able to describe potential safeguarding concerns or describe how they may report such matters.

Doctors and therapists treating people at the service were self-employed. We saw that appropriate checks on the credentials of the therapists had been carried out by the provider. However we were unable to verify that checks had been undertaken on the suitability and qualifications of the doctors practising at the service.

Regular checks to ensure the safety of the premises and the equipment being used were carried out. Information about how the quality of treatment services had been monitored and assessed was not available.