Diamond Skin Care

This service is rated as Inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection of Diamond Skin Care on 8 November 2021, as part of our inspection programme. 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.

Due to the current pandemic we were unable to obtain comments from patients via our normal process of asking the provider to place comment cards within the service location. We saw from reviews on the service website and on Google, that patients were consistently positive about the service, describing staff as professional, helpful and caring. We did not speak with patients as the service did not have patients booked to be seen on the day of the inspection.

Our key findings were:

• The service did not have adequate safety systems and processes in place, or oversight of these, to keep people safe.
• The provider had systems to keep clinicians up to date with current evidence-based guidance. We saw some evidence that clinicians assessed patients’ needs and delivered care and treatment in line with current legislation, standards and guidance. Not all staff had completed training relevant to their role.
• 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.
• The leadership and governance arrangements at the service were not effective. There was little understanding of the management of risks, a lack of assurance and significant failures in the systems and processes to ensure safe, effective and well led services.

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

• Care and treatment must be provided in a safe way for service users.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

The areas where the provider should make improvements are:

• Improve the arrangements in place for the follow up of referral requests made to GPs, for referral on when a skin cancer diagnosis had been made.
• Improve the system to review policies and procedures and document the review dates. This is so there is a clear audit trail of when documents have been reviewed and amendments made, and so policies and procedures are clear, current and reflect the services provided.
• Improve the arrangements for informing patients about the complaints process.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care