THE GRANGE CLINIC LTD

Updated 18 May 2023

The Grange Clinic Ltd is registered with CQC as an independent consulting doctors service providing minor surgery. The service is located at The Grange, 1 Hoole Road, Chester, CH2 3NQ.

The service is owned and run by the provider Aenone Harper-Machin. Services to patients include consultation, investigation and treatment. The service provides a range of minor surgical procedures that are carried out using local anaesthetic. These procedures may be for health and or aesthetic purposes. Services may include; skin surgery to remove lesions (tested for suspected cancer), minor eyelid surgery, minor aesthetic ear surgery, specific breast procedures and other intimate procedures. The range of services provided are listed on the provider’s website. The service also offers a range of other aesthetic procedures that fall outside the scope of CQC registration.

The service operates Monday to Friday from 9am to 5pm. All appointments are pre-bookable.

The service is registered with CQC to provide the following regulated activities: Treatment of disease, disorder or injury and Surgical procedures.

How we inspected this service

We carried out this review remotely. We reviewed information we hold about the service and asked the provider to send us information about the actions they had taken since our comprehensive inspection of the service.

Our review included:

• Speaking with the registered provider

• Reviewing records and supporting information and evidence submitted by the provider.

To get to the heart of patients’ experiences of care and treatment, we 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 form the framework for the areas we look at during an inspection. For the purposes of this inspection we looked at the safe key question.

Updated 18 May 2023

This service is rated as Good overall (Previous inspection 25 April 2022 – Good with requires improvement in the safe key question). At our last inspection we rated the service as ‘Good’ overall and for providing effective, caring, responsive and well-led services. We rated the service as requires improvement for providing safe services because some of the systems and processes required to support safe practice had not been formalised and/or required development.

The key question inspected is rated: Are services Safe? – Good

We carried out this announced focused inspection of The Grange Clinic on 25 April 2023 to follow up on the safe key question and a breach of Regulation 12 of the Health and Social Care Act regulations. We found that improvements had been made and compliance with the regulation had been achieved.

Following our last inspection in April 2022 the provider was required to develop procedures to support the provision of safe care and treatment. These included; Carrying out a review of the policies and procedures for safeguarding children and vulnerable adults. Reviewing risk assessments and producing plans to detail how risks were managed. Introducing a formalised audit of infection prevention and control measures. Carrying out a risk assessment to demonstrate the emergency medicines required. Ensuring a system was in place for receiving and acting upon patient safety alerts. We had also found that there were areas where the provider should make improvements. These included: To assess the training needs of members of the non-clinical team and produce a training plan to ensure these are met. To consider a second stage to the complaints process to include adjudication.

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 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.

The Grange Clinic Ltd provides a range of non-surgical cosmetic interventions some of which are not within CQC scope of registration. Therefore, we do not inspect or report on these services.

The registered manager for the service is Aenone Harper-Machin. 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:

The provider demonstrated improvements to the systems and processes required to support safe practice.

• The service provided care in a way that kept patients safe and protected them from avoidable harm.
• There were systems to assess, monitor and manage risks to patient safety.
• Staff had the information they needed to deliver safe care and treatment to patients.
• The service had systems for the appropriate handling of medicines.
• The service learned and made improvements when things went wrong.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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