The Mole Clinic

Updated 8 August 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. 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 Mole Clinic provides skin checks, including cancer screening and surgical mole removal. The service has recently begun to see children from the age of 13 years to provide basic skin checks. Services are available to any fee-paying patient. The service is provided at Basildon House, 7 Moorgate, London, EC2R 6AF. The provider has another location within London and three satellite clinics. These were not part of this inspection. The provider is the largest independent skin cancer clinic in the UK and sees approximately 14,000 patients a year.

The service is based in an office building. The practice utilises several clinic rooms and a reception area within the premises on the ground floor. There are a small number of steps into the building however, a ramp is available for those with mobility difficulties.

Services are available between 8am to 5pm Monday, Wednesday and Friday and 8am to 7pm on Tuesday and Thursday. Information about opening times are displayed on the service’s website.

The Mole Clinic clinical team consists of seven nurses, one health care assistants and five surgical consultants, specialising in dermatology, with practicing privileges (the granting of practising privileges is a well-established process within independent healthcare whereby a medical practitioner is granted permission to work in an independent hospital or clinic, in independent private practice, or within the provision of community services). The clinical team is supported by a clinic manager, clinic coordinator and a small team of administrative staff.

The service is registered with the CQC to provide the regulated activity of treatment of disease, disorder or injury, diagnostics and screening and surgical procedures.

Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew. During our visit we:

• Spoke with the registered manager and clinical staff
• Reviewed an anonymised sample of the personal care or treatment records of patients.
• Reviewed service policies, procedures and other relevant documentation.
• Inspected the premises and equipment used by the service.
• Reviewed CQC comment cards completed by service users.

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 8 August 2019

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at The Mole Clinic as part of our scheduled inspection programme.

Our inspection team was led by a CQC lead inspector. The team included a GP specialist adviser.

The service provides skin checks, including cancer screening, and mole removal. All tissue samples were sent to a local laboratory where the clinic held a third-party contract.

The clinic had two registered managers; the clinic manager and the organisation founder. 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.

Thirteen people provided feedback about the service. This feedback was positive about the care provided and the kindness and compassion of staff. Patients also told us that their dignity was maintained throughout consultations.

Our key findings were:

• There were clear systems and processes to safeguard patients from abuse. All staff had received training appropriate to their role.
• The clinic manager was trained to level five in safeguarding.
• Risks associated with the service, such as fire and legionella, were managed by the building where rooms were rented. The service requested this documentation on a regular basis to ensure all necessary risk assessments and checks had been completed.
• Staff members were knowledgeable and had the experience and skills required to carry out their roles.
• The Mole Clinic ensured all staff had received mandatory training and an annual appraisal. The service also completed regular reviews of consultations and competency assessments.
• Clinical records were detailed and held securely. The service did not keep paper records. The clinical system used by the clinic enabled diagnostic imaging to be shared quickly with specialist doctors.
• The clinic held regular clinical management meetings and multi-disciplinary team meetings. Minutes were available to all staff via the clinic intranet.
• The service had systems to manage and learn from complaints or significant events. These were shared with the wider organisation and analysed for trends.
• Patients were able to book appointments online and told us this was an easy system to use. The service monitored the availability of appointments to ensure urgent referrals were seen in a timely manner.
• Patients were asked for feedback following each appointment. This feedback was logged, analysed and shared with staff via the clinic intranet.
• All staff were aware of the clinic values and were passionate about providing high level care. We saw that staff were committed to raising awareness of skin cancers and sun safety.
• The service had recently developed a team website where staff could access all policies and procedures, learning from incidents, meeting minutes and relevant documents.

• The clinic had developed a training course for skin cancer screening that was undertaken by all the nursing staff. This was the only course of this nature that had been accredited by the Royal College of Nursing.

The areas where the provider should make improvements are:

• Embed the process for checking parental consent when providing treatment to children.

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