Eterno 360

Updated 25 August 2022

Eterno 360 was first registered with CQC in 2019 and is registered to treat patients aged between 13 and 18 years of age, young adults and older people. The service provides several regulated activities which include doctor-led and nurse-led consultations for a range of aesthetic surgical procedures for the face, body and breasts. The only regulated activity provided to patients under the age of 18 is treatment to correct prominent ears. Activities outside the scope of registration include fat freezing, micro needling, dermal fillers and chemical peels.

The address of Eterno 360 and, that of the provider, Eterno Plastic Surgery Ltd, is The Bridge House, 138 High Street, Eton, Windsor, Berkshire, SL4 6AR. Consultations and minor surgical procedures are carried out on site, however, all other surgical procedures are carried out at local private hospitals which the service has arrangements with. We did not inspect these locations during the inspection.

The clinic is in the centre of Eton and can be accessed by public transport, on foot or by car. The clinic does not have parking on site, however, there is paid parking available nearby.

The opening times are:

Monday: 10am to 5pm

Tuesday: 10am to 5pm

Wednesday: 10am to 8pm

Thursday: 10am to 5pm

Friday: 10am to 5pm

Saturday: 9am to 12pm

Sunday: Closed

The building is leased from a private owner and responsibility for maintenance of the premises is shared between the service and owner according to the terms of the lease. The premises comprise three floors and the only access is from street-level with one step to enter the building. The ground floor includes a reception area and back office, the first floor includes the doctor’s consultation room and a single unisex toilet. The second floor includes a treatment room and the minor surgical procedures room. All floors of the building are accesses by stairs and the toilet is not suitable for wheelchairs. However, the service has arrangements at three private hospitals to provide consultations for any patients with mobility issues to ensure they have equal access to treatment.

The staff team is comprised of the clinical lead, a nurse, and an aesthetician. The team are supported by a clinic manager who is the managing director, an assistant manager and a front of house receptionist.

How we inspected this service

Throughout the COVID-19 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.

The 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 facilities.
• Requesting documentary evidence from the provider.
• A site visit.

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 monitors 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 25 August 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 Eterno 360 between 29 July and 1 August 2022. The inspection was carried out to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. This was the first inspection of the service since it registered with the Care Quality Commission (CQC).

Eterno 360 specialises in medical aesthetic treatments and anti-ageing medicine while also offering rejuvenation treatments for clients. The service provides a mixture of independent doctor-led surgical procedures for the body, face and breast which include prominent ear correction, eyelid surgery, breast augmentation, breast reduction, nipple correction, abdominoplasty, thigh lifts and upper arm lifts, as well as other regulated and 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. Eterno 360 provides a range of non-surgical cosmetic interventions, for example microneedling, dermal fillers, chemical peels and fat freezing which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

Eterno 360 is registered with the CQC to provide the following regulated activities: Treatment of disease, disorder and injury, Surgical procedures, and Diagnostic and screening procedures.

The clinical lead 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.

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 monitors on an ongoing basis. We did not speak to patients on the day of the site visit.

Our key findings were:

• The service used significant incidents as an opportunity to learn and improve when things went wrong.
• Clinical records were clearly written and followed best practice guidance.
• The service had effective systems to monitor, detect, reduce and prevent the risk of infection.
• All staff had access to the information they needed to provide treatment to patients.
• Quality improvement activity was used to measure performance and drive improvement.
• The service asked patients for consent to communicate with their regular GP about their treatment.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The service promoted the delivery of high-quality, person-centred care.
• The practice listened to concerns and feedback and responded to make improvements to the quality of care and access for patients.
• Management were clear about the risks and challenges facing the service and there was a strategy of how to address these.
• The service had a clear vision and values.
• Leaders were approachable, compassionate and inclusive.

We saw the following area of outstanding practice:

• Innovation was used to ensure improvement in clinical care and patient safety was achieved. For example, the service had designed and developed their own clinical system and it was bespoke to their needs. This allowed them to respond quickly when opportunities to improve the clinical system were identified. We found examples where this had happened, and it had improved the quality of care and safety of patients. For example, the service had audited the system and found patient records which did not contain clinical notes. The system was updated to ensure these records were reviewed and rectified by the relevant clinician and it was further updated to continually identify if this happened again and the clinician was prevented from using the system until it was completed. This ensured all staff had access to the information they needed to provide safe care and treatment.

The areas where the provider should make improvements are:

• Review all policies and governance procedures to ensure they are in line with best practice guidance, and operative effectively and consistently to mitigate risks.
• Continue to develop and embed the revised approach to the monitoring of staff immunisations in line with current guidance.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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