Background to this inspection
Updated
23 March 2020
Azara is operated by Mr Dominic Bray. The service opened in September 2018. It is an independent private hospital in Tunbridge Wells, Kent. It serves the communities in Tunbridge Wells, and accepts patient referrals from outside this area and abroad.
The main service the clinic provided is minor cosmetic surgery. All surgery is performed as a day case under twilight sedation or local anaesthetic. Pre and post-operative consultations take place for cosmetic surgery that is performed by the cosmetic surgeon at this hospital.
A range of cosmetic treatments and procedures were available at the clinic. The most common surgeries performed were face and neck lift, platysmaplasty (neck lift), lateral temporal browlift, and upper blepharoplasty (eyelid surgery). The surgeon had the experience, skills and expertise to carry out the procedures and treatments provided at the clinic.
The hospital has had a responsible individual in post since September 2018.
The hospital facilities are laid out over two floors. Situated on the ground floor is the reception, waiting area and three consulting rooms. On the first floor was the theatre, and two bedrooms for inpatients and one for staff. The administrative offices are on the ground floor. There is a toilet on the ground, and first floor.
The clinic provides day case cosmetic surgery and consultation services for adults over the age of 18 years only.
The clinic offers services to self-pay patients. The clinic also offers cosmetic procedures such as dermal fillers and botulinum toxin, laser skin resurfacing and massage therapy. We did not inspect these services, as these are not regulated by the Care Quality Commission (CQC).
This is the services first inspection since registering with the Care Quality Commission (CQC).
Updated
23 March 2020
Azara is operated by Mr. Dominic Bray. The service has two beds. Facilities include one operating theatre, and three clinic rooms.
The service provides cosmetic surgery to patients over the age of 18. We inspected surgery services.
We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 18 September 2019.
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.
Services we rate
We rated it as Good overall.
Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
The service used systems and processes to safely store, prescribe, administer and record medicines.
Patient safety incidents were managed in line with best practice. Staff recognised incidents and reported them appropriately.
The service had an effective system to regularly assess and monitor the quality of its services to ensure patient outcomes were monitored and measured. Clinical audits and risk assessments were carried out to facilitate this. Outcomes for people who used services are positive, consistent and regularly exceed expectations.
Doctors, nurses and support staff worked together as a team to benefit patients. They supported each other to provide good care. All members of the multidisciplinary team supported each other to provide care. Staff respected their colleague’s opinions.
Patients were supported to make informed decisions about their chosen procedures and treatments and were given sensible expectation.
There was a strong visible person-centred culture to providing care in the service. Patients were always treated with dignity and respect. All staff we spoke with were very passionate about their roles and were dedicated to making sure patients received the best individualised patient-centred care possible.
Staff were highly motivated and inspired to offer care that was kind and promoted people's dignity. Relationships between people who used the service, those close to them and staff were witnessed to be strong, caring, respectful and supportive.
Feedback from people who used the service and those who were close to them was continually positive about the way staff treated people.
Staff understood the impact that a person’s care, treatment or condition had on their wellbeing and on those close to them, both emotionally and socially. People's emotional and social needs were seen as being as important as their physical needs.
Staff fully involved patients and those close to them to make decisions about their care and treatment.
Staff treated people who used the services as active partners in their care. They were fully committed to working in partnership with people and making this a reality for them.
The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.
The provider planned services to take into account the needs of different people to allow them to access care and treatment.
Staff were proactive in understanding the needs of different groups of people and in delivering care in a way that met these needs.
Care and treatment were tailored to meet the needs of the individual patients.
The leadership of the service had the right skills and abilities to run a service providing high-quality care.
There was strong collaboration, team-working and support across all functions and a common focus on improving the quality, safety and sustainability of care. Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns.
There were consistently high levels of constructive engagement with staff and people who use services. Services are developed with the full participation of those who use them, staff and external partners as equal partners.
However, we also found areas of practice that required improvement:
The service did not formally record all elements of the WHO Surgical Safety Checklist or audit compliance.
At the time of the inspection the service did contribute to national audits such as Quality Patient Reported Outcomes Measures (Q PROMS) and Private Healthcare Information Network (PHIN).
An additional safeguarding training package had been introduced, not all staff were up to date with this training.
Nigel Acheson
Deputy Chief Inspector of Hospitals (London and South)