The Care Quality Commission
  • Hospital
  • Independent hospital

Archived: Aesthetic Beauty Centre

2 Ashmore Terrace, Sunderland, Tyne and Wear, SR2 7DE (0191) 567 2900

Provided and run by:
Aesthetic Beauty Centre LLP

All Inspections

27 & 28 July 2020

During a routine inspection

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)

26 July 2020

During an inspection looking at part of the service

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 26 July 2020 along with virtual interviews on-line with staff on 27 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 preassessment 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 a significant ongoing risk of harm to patients undergoing cosmetic surgery procedures at this location. We will add full information about our regulatory response to the concerns we have described to a final version of this report, which we will publish in due course.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

13 February 2020

During an inspection looking at part of the service

Aesthetic Beauty Centre is operated by Aesthetic Beauty Centre LLP. The service provided a range of cosmetic procedures under local anaesthetic to fee paying patients over 18 years old.

The service is situated in a large three storey terraced house which has been converted into a number of consulting rooms and an operating room, that is wheelchair accessible to ground floor level (but without ramps) and is located conveniently for access to local public transport networks, but also pay and display close by. Service users arriving were met by staff and directed to a downstairs reception room and waiting area. Adjacent to this were a consulting room and office spaces. There were stairs to the first floor landing and also an electronic stair lift, to an unisex toilet and storage. There was a further stair case and electronic stair case to the consulting rooms and an office space. On the second floor there was a theatre, pre-theatre room, together with a room used by staff as the office.

We inspected this service as a responsive inspection following information, we received relating to concerns about services provided from this location during a follow up inspection at another Aesthetic Beauty Location. We carried out a short notice inspection on 13 February 2020. Following this inspection we issued a notice of decision under Section 31 of the Health and Social Care Act (2008) imposing conditions to suspend the carrying out of any surgical activity which required local anaesthetic at this location until 04 April 2020.

To get to the heart of experiences of care and treatment for patients, 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. The inspection was in response to information received and so does not cover all five key questions. We looked only at those parts of safe and well led that caused concern. We did not consider ratings at these inspections.

Services we rate

We had not previously rated this service which was registered on 31 March 2011. As this was a focussed responsive inspection these inspections 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, that the service provider needs to improve:

  • Care premises, equipment and facilities were unsafe for example there was no ventilation system in the treatment room in accordance to HTM guidance 03/01, therefore, there was a risk of post-operative infection.
  • Infection prevention and control procedures were not robust, for example the emergency trolley was corroded and dusty. The process for the disposal of clinical waste was inappropriate.
  • Medicines were not stored safely, securely or appropriately.
  • Hazardous substances were not stored in line regulations.
  • The was no antimicrobial stewardship, we saw patients’ general practitioners were not informed when a service user was given antibiotics.
  • Patient risk assessments were not always completed and updated in line with best practice.
  • All staff were not aware of their duty to identify and report female genital mutilation.
  • There were no risk assessments in place with regard to the environment and patient care.
  • We found evidence of inappropriate monitoring of patients. This meant patients were not always monitored appropriately during procedures, this meant the provider would not be able to and did not identify patient deterioration in a timely manner.
  • There was poor completion of the world health organisation (WHO) safety checklist. Much of the documentation we reviewed was illegible and not in line with professional standards.
  • There was no audit of pre assessment documentation, to identify improvements which could be made.
  • There was no registered manager for this location at the time of our inspection although the provider had made an application to the CQC.
  • The providers statement of purpose dated 1 January 2020 did not reflect the activities and procedures which were being undertaken during our inspection.

Following this inspection, we told the provider that it must take 19 actions to comply with the regulations. We also issued the provider with three requirement notice(s) that affected Aesthetic Beauty Centre – Sunderland. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

23 January 2014

During a routine inspection

Everyone we spoke with told us they were happy with the services provided by this practice and would recommend the service to family and friends. People told us the service they received was 'Brilliant' and 'Excellent'. They also told us that the staff were 'Efficient and friendly' and how the staff were 'always willing to help'. One person said 'I would not go anywhere else and the owner has such a gentle manner'.

We found there were suitable arrangements for obtaining people's consent for the care and treatment provided to them. People told us they were always asked for any changes in their medical history at each appointment.

We found that people were protected from the risk of infection because appropriate guidance was followed. People told us that the surgery was always very clean when they visited.

People were protected against the risks associated with medicines management because appropriate arrangements were in place to safely manage them.

The practice reviewed the quality of care and treatment being monitored regularly. This helped to ensure that the service was run in the best interests of the people who were using it.

31 January 2013

During a routine inspection

People told us that they were 'Very happy' with the care and treatment they had received. One person said 'I was given time to think about the procedure before I made my mind up' and another said 'I am in the middle of treatment but they make sure I am still happy with what they are doing at each visit'.

The patient health records were up to date and described the treatments that were being provided. People were aware of their treatment plan and told us they understood the information they were given.

All staff that had patient contact had received training and guidance in safeguarding adults and children. In addition, they were provided with appropriate guidance about the safeguarding process for them to follow if they had concerns.

Staff were recruited and selected for the role they undertook and appropriate checks were carried out for consultants who were working under practicing privileges.

There was an effective complaints system available and people were given information about how to make a complaint or raise concerns and although there was no ongoing concerns staff were confident that they would deal with any in line with their policies and procedures.