Royal Tunbridge Wells Skin Clinic Ltd

Updated 8 April 2022

Royal Tunbridge Wells Skin Clinic Ltd is an independent provider of doctor-led dermatology services and the use of botulinum toxin (Botox) to treat a range of medical conditions. Services are provided from dedicated premises within the centre of Royal Tunbridge Wells.

The Registered Provider is Royal Tunbridge Wells Skin Clinic Ltd. Services are provided from:

Cobden House, 25 London Road, Tunbridge Wells, Kent, TN1 1DA.

Opening times are Monday to Saturday, 9am to 6pm. The practice provides emergency telephone support out of hours and has a referral arrangement with a local independent GP service should additional support be required.

Services are provided by a General Medical Council (GMC) registered doctor specialising in dermatology and aesthetics, an aesthetic doctor (who is a company director and the nominated individual), as well as nursing, administration and reception staff.

The provider works closely with other local services to refer patients whom it deems are outside of their scope of practice. Patients can access services on a fee-paying basis only.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews.
• Requesting evidence from the provider.
• A short site visit to the practice.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 8 April 2022

Royal Tunbridge Wells Skin Clinic Ltd was last inspected in January 2020, but it was not rated. This inspection was undertaken to provide a rating for this service.

We carried out an announced comprehensive inspection at Royal Tunbridge Wells Skin Clinic Ltd on 15 March 2022. Overall, the service is rated as Good.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out a focused inspection at Royal Tunbridge Wells Skin Clinic Ltd on 15 and 17 July 2020, in response to concerns about the safe care and treatment of patients and governance arrangements. We found breaches against Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and issued Warning Notices to the provider.

We carried out a further focused inspection on 11 September 2020, to confirm whether the service had met the legal requirements in relation to those breaches of regulations. We found that the provider had made improvements to meet Regulation 17. However, they had not made sufficient improvement in providing safe services. A further Warning Notice was issued against Regulation 12(1) Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following our inspection on 11 September 2020, the provider submitted assurance information and evidence to us electronically to demonstrate improvements they had made. We carried out a remote review of this information to confirm whether the service had taken sufficient action to comply with the regulations. We found that the provider had made improvements since our last inspection and was compliant with the Warning Notice issued.

Royal Tunbridge Wells Skin Clinic Ltd is an independent provider of doctor-led dermatology services and the use of botulinum toxin (Botox) injections to treat a range of medical conditions.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by the Care Quality Commission (CQC) which relate to particular types of regulated activities and services and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Royal Tunbridge Wells Skin Clinic Ltd provides a wide range of non-surgical cosmetic interventions. For example, cosmetic Botox injections, facial fillers and cosmetic laser treatments, which are not within CQC’s scope of registration. Therefore, we did not inspect or report on those services.

The practice is registered with CQC to provide the following regulated activity: Treatment of disease, disorder or injury.

The company chairman and director is the registered manager. A registered manager is a person who is registered with CQC 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.

Our key findings were:

• Care records contained full information on what medicines and treatment had been provided.
• Policies and procedures were comprehensive, up to date and relevant to the service.
• All staff had the appropriate level of training for safeguarding adults and children, relevant to their role.
• Staff training was effective. However, not all staff had received training in recognising the signs of sepsis.
• The service had reliable systems for appropriate and safe handling of medicines. However, some risk assessments for emergency medicines not held at the service required implementing.
• Consent was recorded for appropriately for each procedure.
• Patient feedback was positive about clinical care and treatment experience.
• The service was supportive of patients’ needs and patients were able to access the service.
• There was clear leadership and leaders had the capacity and skills to deliver high-quality, sustainable care.
• The provider had effective processes for planning of the future leadership of the service. For example, appointing a new service manager, who had applied to become the CQC registered manager.
• Governance arrangements were implemented effectively.

The areas where the provider should make improvements are:

• Continue to monitor and implement their schedule to ensure all staff receive training in recognising the signs of sepsis.
• Ensure risk assessments for emergency medicines not required by the service are completed, in line with their action plan.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care