7, 8 & 9 July 2021
During a routine inspection
This service is rated as Good overall. (Previous inspection January 2014. No rating given).
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 an announced comprehensive inspection at Skin Care Network (Barnet) Limited
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 of the Health and Social Care Act 2008.
During the previous inspection in January 2014 we found that the provider did not operate effective recruitment procedures to ensure that, before employing people for the purposes of carrying on the regulated activity, all appropriate information about them was in place and they were of good character. This was because there was insufficient recording to demonstrate that Disclosure and Barring Service (DBS) checks of individual staff had been acquired and that, where needed, staff were entitled to work in the UK. We checked these areas as part of this comprehensive inspection and found this had been resolved.
Skin Care Network (Barnet) Limited is a consultant led dermatology service. The clinical team is comprised of six consultant dermatologists (four male and two female), a clinic manager/head nurse, a lead paediatric nurse, one dermatology nurse, one health care assistant, and one psychologist for cancer services. The clinic is supported by two senior receptionists plus two other receptionists, a clinic assistant, an accountant and a housekeeper.
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 CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Skin Care Network (Barnet) Limited provides a range of non-surgical cosmetic interventions, for example Botox for Hyperhidrosis, which is not within CQC scope of registration. Therefore, we did not inspect or report on these services.
The lead consultant 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.
Our key findings were:
- Care and treatment was delivered in line with current evidence based guidance.
- Clinical staff we spoke with demonstrated a strong understanding of informed consent.
- Patients were provided with high quality information about the treatment provided and to promote healthy lifestyles, including in-house leaflets and videos.
- The provider actively sought feedback from patients, which indicated high levels of patient satisfaction.
- The clinic is actively involved in quality improvement activity.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- The premises were accessible for patients with mobility issues.
- Staff we spoke with gave positive feedback and told us they felt supported.
- There was a strong emphasis on continuous learning and development for staff.
- Lessons were learned and changes made as a result of incidents.
- There is oversight of nursing and non-clinical staff. There were processes in place that enabled the lead clinician to have some clinical oversight of all consultants work.
- The provider held practice privileges at other clinics, which could be used in the event of disruption to the premises.
We saw the following outstanding practice:
- The provider was involved in furthering the understanding and developing this area of medicine. The lead clinician attended national and international meetings to present and discuss developments and new techniques in the field of Dermatology. For example, they had carried out research into the use of Confocal microscopy (RCM) which enables non-invasive imaging of superficial layers of the skin to accurately diagnose Melanoma. They had made presentations to British Association of Dermatology (BAD) in March 2020 and at a conference in New York in May 2021 in relation to their findings.
There were areas where the provider could make improvements and should:
- Develop a process for clinical supervision for the consultants that work at the clinic.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care