Brighton Skin Surgery

This service is rated as Good 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? – Good

We carried out an announced comprehensive inspection of Brighton Skin Surgery on 17 June 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 first rated inspection of the service. The service was previously inspected in December 2017, when it was found that the service did not always provide well-led services and a breach of regulation was identified. We carried out a follow up inspection in March 2018 and the service was found to be meeting all regulations.

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 and using video conferencing.

• Requesting documentary evidence from the provider.

• A site visit.

We carried out an announced site visit to the service on 17 June 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff using video conferencing prior to our site visit.

Brighton Skin Surgery provides an independent, doctor-led dermatology minor surgery service.

Procedures offered include skin tag, cyst, mole, wart and cherry or blood spot removal. The service is based within a local NHS GP practice, Mile Oak Medical Centre, on the outskirts of the city of Brighton and Hove.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of all of the services it provides.

Brighton Skin Surgery 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 medical director 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:

• There were safeguarding systems and processes to keep people safe.
• Arrangements for chaperoning were effectively managed. Staff had received chaperone training and had been subject to Disclosure and Barring Service checks.
• There were effective systems and processes to assess the risk of, and prevent, detect and control the spread of infection. There were processes for auditing of infection prevention control arrangements.
• The monitoring of staff immunisations did not always reflect current guidance.
• There were appropriate arrangements to manage medical emergencies and suitable emergency medicines and equipment in place.
• There had been insufficient action taken to identify and address some legionella, fire safety and health and safety risks which were managed by the host GP practice.
• Clinical record keeping was clear, comprehensive and complete.
• There was evidence of clinical audit, monitoring of patient treatment outcomes and regular auditing of clinical record keeping processes.
• Best practice guidance was followed in providing treatment to patients. For example, excised lesions were routinely sent for histological review.
• There were clear and effective clinical governance and monitoring processes. However, the provider had not sought sufficient assurances that the premises they were leasing were safe and appropriately managed.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Provide information for patients on the service’s website about how to make a complaint.
• Monitor policies to ensure their timely review.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care