Archived: Aesthetic Beauty Centre

Updated 16 July 2021

Aesthetic Beauty Centre is operated by Aesthetic Beauty Centre LLP. The service opened in 2010. It is a private independent cosmetic surgery service in Sunderland, Tyne and Wear. The service primarily serves the communities of Tyne and Wear. It also accepts patient self-referrals from outside this area.

The service also offers cosmetic procedures such as dermal fillers and laser hair removal. We did not inspect these services.

The service has had a registered manager in post since 2010.

Aesthetic Beauty Centre provides the following regulated activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury.

However, all the regulated activities above were subject to a condition that the provider must only undertake minor surgical and cosmetic procedures under local anaesthesia as detailed in its statement of purpose for service users aged 18 or over at this location.

We inspected this location in February 2020 following which CQC took enforcement action. We imposed conditions to prevent the provider from carrying out surgical procedures requiring local anaesthetic until 4 April 2020.

We planned to carry out a full comprehensive inspection in March 2020, prior to the conditions expiring. However, CQC conditions were overtaken due to government restrictions on all independent health providers during the Covid-19 pandemic. The provider assured CQC, in line with government restrictions, they would remain dormant until 01 July 2020. The provider agreed to inform CQC two weeks prior to re-commencing services so this would allow sufficient time for a full comprehensive inspection before the first patients were seen and procedures were booked. We maintained engagement and monitoring activity with the provider and staff provided lists of consultations which showed the service had recommenced prior to 01 July 2020.

We carried out this responsive, focused inspection to ensure improvements to patient care and safety had been made.

Updated 16 July 2021

Aesthetic Beauty Centre (Sunderland) is operated by Aesthetic Beauty Centre LLP. The service is registered to provide a range of surgical and cosmetic procedures under local anaesthetic to fee paying patients over 18 years old.

The service is situated in a large terraced house which has been converted into a clinic, that is wheelchair accessible to ground floor level (but without ramps) and is located conveniently for access to local public transport networks, and there is public parking nearby.

There is a downstairs reception, waiting room, and a consulting room and unisex toilet. There are stairs and an electronic stair lift, to a half landing with a unisex toilet and storage. There is a further staircase and electronic stair lift to the first-floor consulting rooms and an office space. There are further staircases but no stair lifts to the second floor where there is a treatment room and pre-treatment room, together with a room used by staff for administrative purposes.

We inspected this service using our responsive inspection methodology following information we received from the provider that they had carried on provision of their service in breach of conditions in place until 4 April 2020 and when dormant in June 2020. We carried out a short notice announced inspection on 27 July 2020 along with virtual interviews on-line with staff on 28 July 2020.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005. The main service provided by this hospital is Aesthetic Beauty Centre – Newcastle upon Tyne. Where our findings on Aesthetic Beauty Centre – Newcastle upon Tyne – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the Aesthetic Beauty Centre – Newcastle upon Tyne service level.

Services we rate

• We had not previously rated this service which was registered in October 2010. As this was a focussed responsive inspection, we looked at specific areas and did not cover the whole domains on key questions. Therefore, we inspected but did not rate the service. We found the following issues, where the service provider was not meeting regulations:
• The provider had stopped decontamination of their own surgical instruments but had not been able to provide CQC with a copy of a contract or service level agreement to ensure surgical instruments were decontaminated in line with regulations.
• The provider had procured equipment to transport clinical waste or contaminated instruments within the building. This did not meet regulations and was not suitable for its intended use.
• Previous inspections had identified patient risk assessments were not always completed and updated in line with best practice. We found this had not improved at this inspection.
• Previous inspections had identified operation notes were not recorded on appropriate documentation for their purpose. Because of this they were difficult to find and not easily legible. At this inspection we found current consultation notes given to CQC by the provider for review were not always updated from previous consultations which had taken place up to a year ago and legibility remained very poor.
• There were no environmental risk assessments and no risk assessments carried out for new equipment. There were stairs to two floors with stair lifts to the first floor. The provider had carried out no risk assessments and although CQC staff had raised this at a registration visit and at the previous inspection in February 2020, staff had not recognised this as a risk.
• Previous inspections had identified policies within the service did not reflect the environment or accurate processes used within the service. At this inspection we found a new policy and procedure manual had been produced but the old policies remained in place and there were still policies where roles and the environment were not accurately reflected. New patient pathway documentation referred to policies that did not exist or remained unchanged.
• Previous inspections had identified there was no audit of pre-operative risk assessments to ensure these were thorough and complete. At this inspection we found patient pre-assessment documentation was still not fully completed, signed or dated even though patients were booked for surgery.
• Previous inspections identified the leadership team were unable to demonstrate full understanding of their responsibilities in carrying out or managing regulated activities and meeting the standards required by the HSCA regulations. At this inspection we found this had not improved. Some responsibilities had been delegated to a business consultant including the creation of a new policy and procedure manual, but the leadership team were still unable to demonstrate a full understanding of their roles and responsibilities as providers of a healthcare service.
• The provision of out of hours care was not robust. At previous inspections we were not assured a patient who required urgent treatment, when the surgeon was operating at other locations would receive care from medical professionals who would have the appropriate skills and competence. Although the provider assured us there was an agreement in place with a local NHS trust, this could not be provided to us.
• There was out of hours cover provided at another facility where procedures were carried out under practising privileges. However, patients did not stay at the facility overnight following procedures.

However:

• The provider had addressed some areas of infection prevention and control. These included replacements of the theatre table and the sink waste in the treatment room.
• At our previous inspection in February 2020 we had found medicines were not stored securely or correctly, but at this inspection we found the provider had taken actions to rectify this.

Following this inspection, we were not assured the provider had taken sufficient action to comply with all of the Health and Social Care Act (HSCA) 2008 Regulations (2014) and there was an ongoing risk of harm to patients undergoing cosmetic surgery procedures at this location.

We issued two fixed penalty notices on 29 July 2020 for failure to notify CQC as required under the Regulations 12 and 15 of the Care Quality Commission (Registration) Regulations 2009. These were paid by the provider on 13 August 2020

We issued a notice of proposal to cancel the registrations of the provider and registered manager on 25 August 2020. The provider submitted representations to appeal the notices on 22 September 2020. The representations were not upheld and a notice of decision to cancel the registration of both the provider and the registered manager was issued on 12 October 2020.

The provider appealed to the first-tier tribunal in November 2020 against both notices, however, withdrew the appeal on 30 June 2021. Therefore, the notice of decision to cancel the registration of the provider and registered manager took effect on 12 July 2021.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

Updated 16 July 2021

Are services safe?

Care premises, equipment and facilities were unsafe.

Staff did not have knowledge of appropriate regulations or apply national guidelines to ensure patients were safe at all times.

The service did not have the correct equipment, or knowledge of regulations to keep patients safe.

The service did not control infection risk well, although staff kept equipment and the premises visibly clean.

Staff did not always complete and update risk assessments for each patient to remove or minimise risks.

Staff did not always keep detailed records of patients’ care and treatment. Records were not always clear, or up to date.

However:

Staff stored and managed medicines well.

Are services well-led?

The leadership team were unable to demonstrate full understanding of their responsibilities in carrying out or managing regulated activities and meeting the standards required by the HSCA regulations. Leaders did not run the service well. They did not use reliable information systems including organisational policies and processes for staff to follow.

Not all staff understood the service’s vision and values, and how to apply them in their work. Processes were not always focused on the needs of patients receiving care.

Leaders did not operate effective governance processes throughout the service. Staff were not always clear about their roles and accountabilities.

Staff told us they were committed to improving services continually. However, leaders lacked insight and knowledge of regulations to make sufficient improvements.

Leaders and teams did not identify or escalate all relevant risks and issues or identify actions to reduce their impact. There were insufficient plans to cope with unexpected events.

The service did not provide care and treatment based on national guidance and evidence-based practice. Managers did not check to make sure staff followed guidance.

The provider failed to manage the expectations of patients. However, they engaged well with patients and staff felt respected, supported and valued.