Sk:n Epsom

Updated 8 June 2022

Sk:n Epsom provides independent doctor-led dermatology services, offering skin treatments such as prescribing for acne and other skin conditions, and minor surgical procedures, including the excision of moles and other skin lesions. The service also provides non-regulated aesthetic treatments, for example, cosmetic Botox injections, dermal fillers and thread vein treatments, which are not within CQC scope of registration.

The Registered Provider is Lasercare Clinics (Harrogate) Limited, who provide services from more than 50 locations across England.

Sk:n Epsom is located at Epsom General Hospital, Langley Ward, Dorking Road, Epsom, Surrey, KT18 7EG.

The clinic opening times are:

Monday to Thursday: 10am to 8pm

Friday: 9am to 7pm

Saturday: 9am to 6pm

Sunday: 10am to 4pm

The staff team is comprised of a clinic manager and a nurse, supported by aesthetic practitioners who provide only non-regulated aesthetic treatments. Five doctors who specialise in dermatology, provide dermatology consultations and treatments on a sessional basis. One of the doctors is also employed as the medical director for the service. A consultant oral and maxillofacial surgeon provides consultations on a sessional basis. Staff are supported by the provider’s regional and national management and governance teams.

The service is run from self-contained, ground floor premises which are leased by the provider and located within a general hospital setting. The premises include a suite of consultation and treatment rooms, a reception and waiting area. Access to the premises at street level, is available to patients with limited mobility. Toilet facilities are located on the ground floor.

How we inspected this service

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 June 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 of Sk:n Epsom on 27 April 2022 under Section 60 of the Health and Social Care Act 2008. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. This was the provider’s first inspection of the service since it registered with the Care Quality Commission (CQC).

Throughout the COVID-19 pandemic the Care Quality Commission (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:

• Speaking with staff in person, on the telephone and using video conferencing.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 27 April 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff on the telephone and using video conferencing prior to our site visit.

The provider specialises in a combination of medical aesthetic treatments and anti-ageing medicine, as well as offering rejuvenation and dermatology treatments. This service provides independent doctor-led dermatology services, offering a mix of regulated skin treatments and minor surgical procedures, as well as other non-regulated aesthetic treatments.

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. Sk:n Epsom provides a wide range of non-surgical aesthetic interventions, for example, cosmetic Botox injections, dermal fillers and thread vein treatments, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Sk:n Epsom is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury, Diagnostic and screening procedures and Surgical procedures.

The clinic manager 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:

• Staff had received training in key areas. There was a clear plan of training for all staff employed by the service.
• Recruitment checks had been carried out in accordance with regulations, including for staff employed on a sessional basis.
• There were safeguarding systems and processes to keep people safe.
• Arrangements for chaperoning were effectively managed.
• There were appropriate arrangements to manage medical emergencies and suitable emergency medicines and equipment in place.
• There were effective systems and processes to assess the risk of, and prevent, detect and control the spread of infection.
• There were comprehensive health and safety risk assessments and processes in place.
• There was evidence of clinical audit and auditing of clinical record keeping processes.
• Clinical record keeping was clear, comprehensive and complete.
• Best practice guidance was not always followed in providing treatment to some patients prescribed medicines for the treatment of acne.
• There were clear and effective governance and monitoring processes to provide assurance to leaders that systems were operating as intended. Risks were promptly identified and responded to.

The areas where the provider should make improvements are:

• Review processes for the monitoring of patients prescribed medicines for the treatment of acne, in order to promote consistency of approach in following current guidance.
• Continue to develop a revised approach to the monitoring of staff immunisations in line with current guidance.
• Review processes to ensure the attendance of a chaperone is recorded in clinical records.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care