4 January 2023
During a routine inspection
This service is rated as Requires improvement overall.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
We previously carried out an announced comprehensive inspection of Diamond Skin Care, Norwich on 8 November 2021. The service was rated as inadequate overall and for providing safe and well led services, requires improvement for providing effective services and good for providing caring and responsive services. As a result of the findings on the day of the inspection, the practice was issued with a warning notice on 18 November 2021. The practice was placed into special measures.
On 1 February 2022, a focused inspection was carried out to review compliance with the breaches identified in the warning notice only. It was found that the provider had made improvements to mitigate the risks identified in the warning notice.
This inspection on 4 January 2023 was an announced comprehensive inspection of Diamond Skin Care Norwich, to follow up on breaches of regulations and to re-rate the service.
Diamond Skin Care Limited is registered under the Health and Social Care Act 2008 to provide the following regulated activities:
- Diagnostic and screening procedures
- Surgical Procedures
- Treatment of disease, disorder or injury.
This service provides a full range of independent dermatology services, offering a mix of regulated skin treatments as well as other non-regulated aesthetic treatments. 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. We only inspected and reported on the services which are within the scope of registration with the CQC.
The Director of Diamond Skin Care 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:
- Since the previous inspection in November 2021, improvements had been made by the service. However, the service had not acted upon all the concerns previously identified and did not have all the necessary safety systems and processes in place or oversight of these, to keep people safe.
- The provider had systems in place to keep clinicians up to date with current evidence-based guidance. We saw evidence that clinicians assessed patients’ needs and delivered care and treatment in line with current legislation, standards and guidance.
- Staff treated patients with compassion, respect and kindness and involved them in decisions about their care.
- The service encouraged and valued feedback from patients. Feedback was positive which included timely access to the service.
- There was a lack of understanding of the management of risks and a lack of assurance in the systems and processes to ensure safe and well led services.
The areas where the provider must make improvements as they are in breach of regulations are:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the provider should make improvements are:
- Continue to implement the new system for recording verbal consent.
- Improve the arrangements for informing patients about the complaints process.
I am taking this service out of special measures. This recognises the improvements that have been made by this service.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services