Cosmetic Skin Clinic

Updated 4 November 2022

The Cosmetic Skin Clinic is one of two registered locations (Devonshire Place, London and Stoke Poges, Buckinghamshire) for the provider, The Private Clinic CSC Limited. This report and findings refer solely to the service provided at the Buckinghamshire location.

In February 2019, The Private Clinic of Harley Street Limited (the provider) acquired the clinic from a different provider and added both locations to The Private Clinic of Harley Street Limited existing portfolio of services. The Cosmetic Skin Clinic then became The Private Clinic CSC Limited and provides a small range of treatments for people aged over 18 that come under scope of regulation by the Care Quality Commission (CQC). These treatments are given via pre-bookable appointments. Patients attend for an initial consultation, where a treatment plan is discussed and agreed, and then they are booked in for treatment at a later date. Only specific treatments are regulated by CQC and they include treatment for excessive sweating (hyperhidrosis) and non-surgical treatments for example, non-surgical thread lifts (a treatment to lift and support facial skin using threads and cogs).

Treatments are provided from:

• The Cosmetic Skin Clinic, 84 Rogers Lane, Stoke Poges, Buckinghamshire, SL2 4LF

The service website is: www.cosmeticskinclinic.com

The Cosmetic Skin Clinic is located in a renovated residential property, formally a GP practice and comprises of treatment rooms, offices and a reception area.

The service is open every weekday with core opening hours of 9am to 5pm. In addition to the core opening hours, the service is open until 7pm every Monday and 6pm every Tuesday, Wednesday and Thursday. The clinic is also open every Saturday between 9am and 5pm. This service is not required to offer an out of hours service. Patients who need medical assistance out of operating hours can access out of hours support via the service and this is detailed in patient literature supplied by the service.

Regulated activities (treatments regulated by CQC) are provided by a cosmetic doctor who is registered as both a medical doctor and a dentist with extensive qualifications in aesthetic medicine. The Head of Clinical Services (Non-Surgical) leads a small team of managers, reception, administration and coordinator staff who undertake the day-to-day management and running of the service. Staff are also supported by the provider’s regional and national management and governance teams.

How we inspected this service

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.

We carried out this inspection on 21 October 2022. Before visiting the location, we looked at a range of information that we hold about the service. During our visit, we interviewed staff, reviewed documents and clinical records, and made observations relating to the service and the location it was delivered from.

Due to the current pandemic, we were unable to obtain comments from patients via our normal process where we ask the provider to place comment cards in the service location. However, we were shown examples of patient feedback which the provider monitored on an ongoing basis. We did not speak to patients on the day of the site visit.

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 4 November 2022

This service is rated as Good overall.

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 The Cosmetic Skin Clinic in Stoke Poges, Buckinghamshire on 21 October 2022. The service was registered with the Care Quality Commission (CQC) in March 2019. We carried out this first rated inspection as part of our regulatory functions. The inspection was undertaken to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

The Cosmetic Skin Clinic provides a range of independent dermatology services, including non-surgical cosmetic interventions, which are not within CQC scope of registration. We did not inspect, or report on, those services that are outside the scope of registration.

The service is registered with the CQC to provide the following three regulated activities:

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

Therefore, we only inspected treatments relating to medical conditions which include treatment for excessive sweating (hyperhidrosis) and non-surgical treatments for a range of skin conditions.

The Head of Clinical Service (Non-Surgical) is the CQC registered manager. A registered manager is a person who is registered with the 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:

• There were clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• The leadership team organised and delivered services to meet patients’ needs following best practice guidelines.
• Staff were highly skilled and kept up to date in their specialist field. They reviewed and monitored care and treatment to ensure the services provided were effective.
• Feedback from patients was consistently positive and highlighted a strong person-centred culture. Other feedback commented the treatment had given the patient extra confidence due to an improved appearance.
• Services were tailored to meet the needs of individual fee-paying patients. Treatments were delivered in a flexible way that ensured choice and where appropriate, continuity of care.
• There was a clinic-specific vision which linked into the overarching provider vision and strategy. We saw evidence of good local leadership and good integration with the provider and other services within the provider group.

We saw an area of outstanding practice:

• Leaders had the integrity, skills and abilities to run the service. They had a deep understanding of issues, challenges and priorities within the aesthetic sector, and beyond. There was evidence of innovation and engagement with external stakeholders. Shared work across the sector included engagement with the Joint Council of Cosmetic Practitioners and the Chartered Institute of Environmental Health to deliver safe change and improvement to the sector. Further opportunities to participate in benchmarking and peer review were proactively pursued.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services