We carried out an announced comprehensive inspection on 6 February 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.

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.

CQC last inspected this service on 31July 2013. That was an unannounced inspection and the service met all standards assessed.

Laserase Bolton is a private clinic that provides medical and cosmetic treatments to day patients using a range of none or minimally invasive procedures. The service treats adults and children between the age of five years and eighteen years. All children are treated by a doctor and all procedures are carried out by healthcare professionals.

A registered manager was in post at this location however they were not available on the day of inspection. 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 Care Quality Commission (CQC) comment cards to be completed by patients prior to our inspection visit. We received 70 comment cards which were all very positive about the standard of care received. Comments included; ‘Excellent service,’ ‘All options were discussed and all questions answered,’ ‘Procedures were explained,’ ’Clinical areas are immaculate,’ ‘Very happy with the results,’ ‘Treated with dignity and respect’ and ‘Excellent service.’

Our key findings were:

• There were policies and procedures in place for safeguarding patients from the risk of abuse. Staff had received training in safeguarding at an appropriate level to their role and knew who to go to for further advice.
• Recruitment policies and procedures were in place. There were enough staff to meet the demand of the service and appropriate recruitment checks for all staff were in place.
• The premises were clean and systems and practices were in place for the prevention and control of infection to ensure risks of infection were minimised. Personal protective equipment (PPE) was readily available.
• Patients’ needs were assessed and treatment was discussed and planned with the patient and written consent obtained prior to treatment being given.
• Staff felt supported and had access to appropriate training.
• Patients comments were they were treated with dignity and respect. Patients were given good verbal information and an information fact sheet pre procedure and a post procedure information sheet.
• Opening times of the service were clearly displayed on the website and in the patient information guide.
• There was a system in place to manage complaints.
• There were systems in place to monitor and improve quality and identify risk.
• Patient satisfaction views were obtained.
• There was a clear vision to provide a safe and high quality service. Staff felt supported by management and worked well together as a team.
• The doctor we spoke with and the director we spoke with were aware of and complied with the duty of candour.

Laserase Bolton provided a wide range of information for clients prior to and during treatments. People who used the service were given appropriate information and support regarding their treatment.

Client feedback and views were obtained on a regular basis and these were collated into an annual report. We found all comments made were very positive. Clients rated various aspects of the service either good or excellent.

Only one client agreed to speak with us on the day of inspection. Comments included: "I have always found the staff very professional, everything is explained and I feel able to make any comments".

We sampled four client treatment records and found them to contain all relevant information. Fact sheets were given to clients at the end of the session and a check list for after care was completed. This included advice about using sun screens and how to look after the area treated.

Laserase Bolton had appropriate human resources (HR) policies and procedures in place.

We found that the service had systems in place to monitor the quality of the service provided. Audits were undertaken and these included monitoring the completion of client treatment records. We found the audit demonstrated treatment records were well maintained.

The clinic provided treatments in a clean and well maintained , modern environment.

During the time of inspection there were no clients being treated. We sampled the files of five clients who had undergone or were completing a course of treatments with one of the five lasers in the clinic. We found that appropriate consent and skin testing had been undertaken prior to commencing a course of treatments. These were dated and signed by both the client and practitioner. We found that medical checks were made to verify if clients were suitable for the proposed treatments.

As there were no clients being treated in the clinic, we gained permission to contact the two staff employed as laser practitioners, by telephone during the inspection. The staff told us "I do feel that the clinic manager and provider communicate well, as we were only the two staff employed to carry out the laser treatments" and "We get training on all the new treatments and we keep updated".

We found that the service had an appropriate system in place to monitor the quality of the service provided and there was a current policy and procedure to ensure that complaints about the service were effectively managed