Liverpool Skin Clinic

Liverpool Skin Clinic is operated by Liverpool Skin Clinic Limited. The service is based in Mossley Hill, Liverpool and provides hair transplant cosmetic surgery and platelet-rich plasma hair restoration therapy for private fee-paying adults.

The clinic facilities are on the ground floor, which include a reception and office area, a waiting room, a consultation room, a bathroom, a kitchen, two treatment rooms and a stock room. There is a washroom with a backwash sink unit that is used to shave and wash patients’ hair before procedures and an additional surgical wash area used for after care. Treatment rooms and waiting rooms are easily accessible with a ramp if required for the two steps leading to the washroom.

We rated it as inadequate because:

• Mandatory training did not cover all key skills and the service did not monitor compliance. Staff did not always complete training on how to recognise and report abuse. Not all staff had been safely recruited through pre-employment checks. The service did not always control infection risk well and did not have a process to monitor surgical site infections. Staff did not ensure equipment was maintained to keep people safe. They did not manage clinical waste well. Staff did not always complete documented risk assessments or record follow up discussions to identify or minimise any risks. The service did not always follow their own processes to manage medicines and could not be sure that staff knew how to store and dispose of medicines safely
• The service did not always provide care and treatment based on national guidance and evidence-based practice. The service did not carry out an audit for patient outcomes to evidence good outcomes or use the findings to make improvements. Not all staff had an appraisal or supervision meetings to measure staff competency and provide support and development. The service did not always have clear documentation to evidence that consent was in line with national guidance or that patients gave consent in a two-stage process with a cooling off period of at least 14 days between stages.
• The complaints procedure was not displayed or explained to patients as to how they could give feedback and raise concerns about care received. The service did not have an effective complaints policy in place to respond to concerns and complaints appropriately.
• Leaders did not demonstrate the necessary skills and abilities to run the service. They did not always understand and manage priorities and issues the service faced. The service did not have a formally documented vision for what it wanted to achieve and a strategy to turn it into action. Leaders did not operate effective governance processes. Staff did not have regular opportunities to meet, discuss and learn from the performance of the service. The service did not use systems to manage risk, issues, or performance effectively. They did not have clear plans to cope with unexpected events. The service did not collect and analyse data to understand performance or make decisions and improvements. The service did not have clear plans for learning, continuous improvement or innovation.

However:

• Equipment and the premises were visibly clean and the service had suitable premises and facilities to meet the needs of patients. The service had a process to identify and quickly act upon patients at risk of deterioration.
• Staff gave patients enough food and drink to meet their needs. Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way. All staff worked together as a team to benefit patients. They supported each other to provide good care. Patients could contact the service seven days a week for advice and support after their surgery. Staff gave patients practical support and advice.
• The service planned and provided care in a way that met the needs of local people. The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. People could access the service when they needed it and received the care in a timely way.
• Staff we spoke with felt respected, supported and valued. Staff told us they were focused on the needs of patients receiving care. The information systems were secure.

Following our inspection, we issued the provider with one section 29 Warning Notice for Regulation 17 HSCA (RA) Regulations 2014 Good governance. We also issued the provider with a requirement notice for Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.