Signature Clinic - Central London Also known as Signature Medical Ltd

Updated 21 December 2023

Signature Clinic – Central London is operated by Signature Medical Limited. The service offers a range of cosmetic surgery treatments for adults over 18 years old. The service provided a range of other cosmetic procedures that are out of scope for regulation.

The main service provided by this hospital was cosmetic surgery, the provider is registered for the regulated activities: Surgical procedures and Treatment of Disease, Disorder, or Injury.

100% of patients were self-paying patients.

The cosmetic surgery services are provided from the clinic location in West London, London. The provider had two theatres available. The service provided day case surgeries and did not have facilities for overnight stays.

There was a total of 1744 procedures carried out between August 2022 and July 2023. The top three procedures were upper blepharoplasty, lower blepharoplasty and gynaecology surgeries.

Following the inspection, we served the provider a Warning Notice under Section 29 of the Health and Social Care Act 2008. The Warning Notice told the provider they were in breach of Regulations 12 Safe Care and Treatment and Regulations 17 Good Governance and gave the provider a timescale to make improvements to achieve compliance. The principles we use when rating providers requires CQC to reflect enforcement actions in our ratings. The warning notice identified concerns in the safe and well-led domains. This means that the warning notice we served had limited the rating for safe and well-led to inadequate. The provider was also served with two requirement notices, details of these notices can be found at the end of this report.

Updated 21 December 2023

This was the first time we rated this service. We rated it as inadequate because:

• Over the last 12 months the service did not have enough suitably qualified staff to care for patients and keep them safe.
• There was poor adherence to infection prevention controls.
• The service did not manage medicines well and we were not assured that staff were following the services policies when administering medicines to patients.
• The service did not keep good patient records, all hand-written notes in patient care records that were reviewed were illegible.
• We saw a lack of clinical incidents and we could not be assured how well clinical incidents were recorded. We were not assured that lessons could be learnt from them.
• Managers did not monitor the effectiveness of the service or made sure staff were competent. Staff did not have access to key information. Pain relief was offered to patients when they needed it, however medications were often handed out by unqualified staff. Staff did not advise patients on how to lead healthier lives.
• Negative feedback was discouraged, and patients were ill-informed about the complaints procedure.
• Leaders did not support staff to develop their skills.
• Staff did not understand the service’s vision and values, or how to apply them in their work.
• Governance processes were not robust, and we found incomplete key lines of communication between the senior leadership team and junior staff. There was a lack of formal recording in meeting minutes to cascade information. Not all risks identified on the inspection were known to the provider.
• The service did not engage well with patients or staff to plan and manage services.

However:

• For the majority of patients staff treated them with compassion and kindness. They provided emotional support to patients, families and carers, whilst they were at the clinic. The aftercare team supported patients well post operatively.
• Staff worked well together for the benefit of patients.
• Staff felt respected, supported and valued by members of senior leadership team.
• The service provided refreshments for patient and friends and family.
• After-care was available seven days a week.

Updated 21 December 2023

This was the first time we rated this service. We rated it as inadequate because:

• Over the last 12 months the service did not have enough suitably qualified staff to care for patients and keep them safe.
• Safeguarding knowledge was limited and was not understood by all staff, the policy and training was not up to date.
• There was poor adherence to infection prevention controls.
• The service did not manage medicines well and we were not assured that staff were following the services policies when administering medicines to patients.
• The service did not keep good patient records, all hand-written notes in patient care records that were reviewed were illegible.
• We saw a lack of clinical incidents and we could not be assured how well clinical incidents were recorded. We were not assured that lessons could be learnt from them.
• Managers did not monitor the effectiveness of the service or made sure staff were competent. Staff did not have access to key information. Pain relief was offered to patients when they needed it, however medications were often handed out by unqualified staff. Staff did not advise patients on how to lead healthier lives.
• Negative feedback was discouraged, and patients were ill-informed about the complaints procedure.
• Leaders did not support staff to develop their skills.
• Staff did not understand the service’s vision and values, or how to apply them in their work.
• Governance processes were not robust, and we found incomplete key lines of communication between the senior leadership team and junior staff. There was a lack of formal recording in meeting minutes to cascade information. Not all risks identified on the inspection were known to the provider.
• The service did not engage well with patients or staff to plan and manage services.

However:

• For the majority of patients staff treated them with compassion and kindness. They provided emotional support to patients, families and carers, whilst they were at the clinic. The aftercare team supported patients well post operatively.
• Staff worked well together for the benefit of patients.
• Staff felt respected, supported and valued by members of senior leadership team.
• The service provided refreshments for patient and friends and family.
• After-care was available seven days a week.