Chiltern Medical Clinic, Goring on Thames

Updated 20 May 2020

Chiltern Medical Clinic, Goring on Thames is operated by Medical Skin Clinics Ltd. The service was established in 2002 and moved to its current location in 2006. It is a private clinic in Goring on Thames, Berkshire. It serves the local community and accepts patients from outside this area. There is a second clinic located in Reading, Berkshire also managed by Medical Skin Clinic Ltd which shares some services and staff with Chiltern Medical Clinic. The Reading Clinic was not inspected.

We inspected surgery. The service provides cosmetic surgery such as mole and other skin lesion surgery, blepharoplasty (surgery to remove excess skin or fat from the eyelids) and earlobe repair. All surgery is performed as a day case under local anaesthetic. Pre and post-operative consultations take place at the clinic.

The clinic offers a range of services including laser hair removal, skin fillers, cosmetic treatments and other laser treatments. We did not inspect these services, as they are not regulated by the Care Quality Commission (CQC).

The clinic has had a registered manager in post since 2007. The current manager has been in post since March 2019.

The clinic offers services to self-pay and privately insured patients.

The service was previously inspected in 2014 when four out of five standards were met. A follow up desk based review found appropriate actions were taken and all standards were met.

Updated 20 May 2020

Chiltern Medical Clinic, Goring on Thames is operated by Medical Skin Clinics Ltd. The service sees patients on a day case basis and has no overnight beds. Facilities include three treatment rooms and two consulting rooms. There are two waiting areas for patients.

The service provides cosmetic surgery to patients over the age of 18. The clinic provides some treatments not regulated by the Care Quality Commission (CQC) for children. We inspected surgery services.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 27 February and 9 March 2020.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

We rated this service as Requires improvement overall.

• Leaders did not operate effective governance processes, throughout the service. There was limited local clinical audit to make improvements and achieve good outcomes for patients. The service did not have systems to identify and manage service risks to reduce their impact.
• Storage of medicines was not in line with clinic policy or best practice.
• The clinic did not make an assessment of the need to carry out disclosure and barring service checks on their administration and support staff as part of their recruitment process.
• Not all equipment had an electrical safety check in line with the local policy. Emergency equipment was not stored in one location so we were not assured staff would know how to locate this..
• The service did not have a protocol for the recording of patient psychological assessments and the subsequent need for referral.
• The service did not provide mandatory training in key skills for all staff. On the second day of inspection we did see arrangements were being made to purchase on line training for all staff.
• There were gaps in the support arrangements for staff including an annual appraisal. On the second inspection day we saw one appraisal was complete and plans were in place to complete this process for all staff.
• The service did not have arrangements in place for people who need translation services.

However:

• The design, maintenance and use of facilities and premises kept people safe. Staff used control measures to protect patients, themselves and others from infection. They kept equipment and premises visibly clean.
• Staff completed and updated patient assessments. The service had enough staff with the right qualifications, skills and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Staff recognised and reported incidents and near misses.
• The service provided good care and treatment, gave patients enough to drink and gave them pain relief when they needed it. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and patients had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them to understand their conditions. They provided support to patients, families and carers.
• The service planned and provided care in a way that met the needs of local people, took account of patient’s individual needs and made it easy for people to give feedback. People could access services when they needed, and the service was flexible to patient requests for appointments and treatments.
• Leaders had the skills to run the service. Staff understood the service’s vision and values and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged with patients, staff and the public and staff were committed to developing their skills.

Updated 20 May 2020

Surgery was the main activity of the service. We rated this service as requires improvement in safe, effective and well led. We rated it as good in caring and responsive.