We carried out an announced comprehensive inspection on 5 September 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 Doctors Laser Clinic Ltd is a medical skin laser and aesthetic clinic. They offer laser tattoo, hair and thread vein removal, laser treatment for stress urinary incontinence and genitourinary syndrome of menopause, dermal fillers, and Botulinum Toxin (Botox) treatments for cosmetic purposes and medical purposes for example, Hyperhidrosis (excessive sweating). The service is registered as an NHS provider for transgender laser hair removal.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment of patients suffering with a medical condition which can be treated with the use of a laser or Botulinum Toxin. The treatment of patients with Botulinum Toxin was undertaken by registered doctors and nurses. The treatment of patients with a laser for stress urinary incontinence and genitourinary syndrome of menopause was undertaken by a doctor. At The Doctors Laser Clinic Ltd the aesthetic cosmetic treatments, including the use of laser treatment for tattoo and hair removal and dermal fillers, are exempt by law from CQC regulation and were therefore not inspected. Regulated activities are not carried out on clients under the age of 18 years.

The service is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures.

The Doctors Laser Clinic Ltd opened in 2010 and is run by three doctors of whom one 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.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection visit. We received 22 comment cards from patients who provided feedback about all aspects of the service. They were all very positive about the standard of care received. Comments included that the service provided excellent advice and support and that the staff were friendly, knowledgeable, kind and caring.

Our key findings were:

• There was an effective system in place for reporting and recording significant events and these were monitored to completion. There was a process for sharing the learning within the service, when appropriate.
• The service had systems in place for the receiving of and acting on, safety alerts regarding the monitoring of medicines or devices.
• The service had several policies and procedures which were in place to govern activity.
• Risks to patients were assessed and well managed. The service did not carry out fire drills however staff were aware of their duties, where the fire assembly point was situated, and the fire equipment checks were up to date. The service had a fire safety policy and a fire risk assessment. Following the inspection, the provider took some action in relation to this finding and carried out a fire drill and updated the risk assessment to ensure annual fire drills were undertaken.
• There was an in-depth infection prevention and control audit, risk assessment and policies and procedures were in place to reduce the risk and spread of infection.
• Medicines were safely managed. There was evidence that checks had been undertaken, there were records to demonstrate that medicines near to their expiry date had been ordered and supplied.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• The service provided an out-of-hours telephone service for patients with concerns post treatment and had a system in place to ensure a clinician was available in an emergency.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were listened to, treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about the service and how to complain was available and easy to understand.
• There was an effective system for responding to and learning from complaints.
• The service was aware of and complied with the requirements of the Duty of Candour.
• Systems were in place to ensure that all patient information was stored and kept confidential.
• There was a clear leadership structure and staff felt supported by management.
• The service proactively sought feedback from staff and patients, which it acted on.