A New You (Brighton) Limited

Updated 4 October 2022

A New You (Brighton) Ltd is an independent provider of consultations and treatment for dermatological conditions, including acne and rosacea, prescription skincare and mole screening. Botox (Botulinum toxin) injections are provided for the treatment of excessive sweating. The service also provides nurse-led pre-assessment consultations, for patients seeking surgical procedures outside of the service. The service offers consultations and treatments to people over the age of 18.

The Registered Provider is A New You (Brighton) Ltd.

A New You (Brighton) Ltd is located at 78 Trafalgar Street, Brighton, East Sussex, BN1 4EB.

The service is open from 10am to 6pm on Mondays, Wednesdays and Fridays, 10am to 8pm on Tuesdays and Thursdays and 10am to 5pm on Saturdays.

The service is run from self-contained ground floor premises which are leased by the provider. The service has a suite of consultation and treatment rooms, a waiting room and administration area. Patients are able to access toilet facilities on the ground floor. Access to the premises at street level is available to patients with limited mobility.

Services are currently managed by the service director who is a registered nurse and carries out pre-assessment consultations for patients seeking dermatological review or surgical procedures. The service director is supported by nurses and administrators, and also aesthetic practitioners who are not involved in the delivery of regulated activities. At the time of our inspection, one consultant dermatologist provided remote review of patients’ lesions under a service level agreement. There were no other doctors employed by the service who were involved in the delivery of regulated activities.

How we inspected this service

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 4 October 2022

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out this announced comprehensive inspection of A New You (Brighton) Ltd on 4 August 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.

The service was previously inspected on 5 July 2021. We identified breaches of regulation and took enforcement action against the provider in relation to Regulation 12(1) Safe care and treatment and Regulation 17(1) Good governance. We issued a Notice of Decision under Section 18 of the Health and Social Care Act 2008 to suspend the provider’s registration as a provider, in respect of all regulated activities, for a period of three months. The notice to suspend the provider’s registration was issued because we believed that a person would or may be exposed to a risk of harm if we did not take this action. We also issued a requirement notice in relation to Regulation 18(1) Staffing.

Following our inspection on 5 July 2021, the service was rated as inadequate overall and inadequate for providing safe, effective and well-led services. It was rated as requires improvement for providing caring services and good for providing responsive services. The service was placed into special measures.

We carried out a focused inspection of the service on 9 February 2022. We found that sufficient improvements had been made to lift the suspension of the provider’s registration. However, we identified continuing breaches of regulation and issued a warning notice in relation to Regulation 17(1) Good governance. We carried out a further review on 19 April 2022, to confirm that the provider had taken sufficient action to comply with the regulations.

Throughout the COVID-19 pandemic 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 on the telephone.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 4 August 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff on the telephone prior to our site visit.

A New You (Brighton) Ltd is an independent provider of consultations and treatment for dermatological conditions, including acne and rosacea, prescription skincare, and the screening and treatment of skin lesions. Botox (Botulinum toxin) injections are provided for the treatment of excessive sweating. The service also provides nurse-led pre-assessment consultations, for patients seeking surgical procedures outside of the service.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. 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. A New You (Brighton) Ltd also provides a wide range of non-surgical aesthetic interventions. This includes cosmetic Botox injections, dermal fillers and facial thread vein treatments, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

A New You (Brighton) Ltd is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening procedures. Prior to our inspection in July 2021, we identified that the provider was carrying out the excision of moles and other skin lesions without being registered to provide the required regulated activity Surgical procedures. The provider continues not to be registered for this regulated activity and currently provides only non-regulated treatment of skin lesions, such as non-invasive plasma fibroblast therapy, a technique used to stimulate production of collagen in the skin.

The service 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 improved safeguarding systems and processes to keep people safe. Staff had received training in the safeguarding of children and vulnerable adults.
• Arrangements for chaperoning were effectively managed. Staff had received chaperone training and had been subject to Disclosure and Barring Scheme (DBS) checks.
• Arrangements to manage medical emergencies had been adequately risk assessed. Staff had received training in basic life support.
• There were improved systems for the safe and appropriate use of medicines. However, some recent risks associated with the storage of medicines requiring refrigeration had not been promptly addressed.
• There were improved systems and processes to assess the risk of, and prevent, detect and control the spread of infections. This included processes to maintain and monitor staff immunisations.
• There was a lack of records to demonstrate that recruitment checks had been carried out in accordance with regulations for some staff employed on a trial basis.
• There were improved arrangements to ensure training for staff in key areas. However, there had been insufficient monitoring to ensure update training was received in a timely manner.
• There were improved processes for performance review and staff appraisal.
• There were improved risk monitoring processes which resulted in more accurate assessment of potential risks in some areas. However, there had been insufficient action taken to monitor some fire safety risks.
• Prescribing practices had been recently monitored. There was some auditing of clinical and prescribing processes which required further embedding.
• Governance and monitoring processes were improved but required further embedding to provide assurance to leaders that systems were operating as intended.
• Some steps had been taken to ensure best practice guidance was now followed in providing treatment to patients. There were improved arrangements to ensure the safe delivery of dermatology services.
• There were improvements to ensure consistency in clinical record keeping and the collation of key records and documents.
• Policies had been revised to provide updated, relevant and sufficient information, to provide effective guidance to staff.
• Staff dealt with patients with kindness and respect.
• Patients were routinely asked to provide feedback on the service they had received. Complaints were managed appropriately.

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.
• 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:

• Provide information for patients on the service’s website about how to make a complaint.
• Continue to embed and review governance, monitoring and auditing processes to provide assurance they are operating as intended.

We found that sufficient improvements had been made to remove the service from special measures.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services