Medical Arts for Cosmetic Surgery is operated by Medical Arts for Cosmetic Surgery Limited. The service provides cosmetic surgery and outpatient consultations, including pain management. Facilities include one procedure room, a recovery room, and three consultation rooms.

The clinic provides surgery and outpatients. We inspected surgery and outpatients.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection (we gave staff 48 hours’ notice that we were coming to inspect) on 28 and 30 November 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this clinic was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service report.

See the surgery section for main findings.

Services we rate

We found safe, effective, caring and responsive were good, and well-led was requires improvement. This led to a rating of Good overall.

We found areas of good practice:

• Staff cared for patients with compassion, kindness and respect. They made sure that people’s privacy and dignity needs were understood and always respected.
• The clinic had enough medical, nursing and support staff with the appropriate skills, knowledge and experience to deliver safe and effective care, support and treatment.
• The service continued to treat incidents and complaints seriously. Managers investigated them, shared lessons learned with staff, and made improvements to service provision where indicated.
• Hygiene practices had improved and staff followed infection prevention and control practices to reduce risks to patients.
• Risks to patients were assessed and their safety was monitored and managed so they were supported to stay safe.
• The service had suitable premises and equipment and looked after them well. Managers had improved the arrangements for clinical waste and equipment maintenance.
• The management team promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff worked well together and were committed to providing the best possible care for their patients.
• Patients were supported to make informed decisions about their chosen procedures and treatments, and were given sensible expectations.
• Patient records were clear, up-to-date and complete. They were easily accessible to staff.

We also found areas of practice that were outstanding:

• Staff worked especially hard to make the patient experience as pleasant as possible. The consultant surgeon went above and beyond expectations to ensure patients were fully consulted and had realistic expectations before they agreed to perform any cosmetic surgery. They prepared a detailed electronic presentation for each patient’s planned surgery, which they went through during the consultation. Patients were encouraged to ask questions and could contact the consultant surgeon or clinic staff at any time. Detailed patient feedback was sought and any concerns or negative feedback received was reviewed immediately and improvements were made. Patient feedback was overwhelmingly positive about the registered manager and clinic staff, and the care they provided.

However, we also found areas of practice that require improvement:

• The provider had not taken sufficient action to deal with some of the areas we told them they must improve following our last inspection. While there was a programme of clinical and internal audit in place, we found completed audits lacked detail and it was not clear how often risks were reviewed.

• The provider did not have effective governance arrangements in place to assure themselves that nursing staff had current professional registration and had completed mandatory training. This was outstanding from the inspection in July 2017.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)