15 January 2020
During an inspection looking at part of the service
Harley Health Village is operated by Linia Ltd. The service provides cosmetic surgery for privately funded patients over the age of 18 years of age.
The service is located in a multi-storey building, spread over the lower ground, ground floor and first floor. The service has six recovery beds on the ground and lower ground floors. The service has three admission and discharge rooms, which are also used for overnight stays. Facilities include two operating theatres, a consulting room, reception area and training/meeting rooms.
We last carried out an announced comprehensive inspection of the service in January 2017. At the last inspection, we did not have a legal duty to rate cosmetic surgery services when provided as a single specialty service.
We re-inspected this service using our comprehensive inspection methodology on 15 January 2020 in order to rate the service. Our inspection was announced, staff knew we were coming, to ensure that everyone we needed to talk to was available.
To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
Services we rate
This was the first time we are rating this service. We rated the service as good because:
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The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients and acted on these assessments. The service kept detailed records of care and treatment. They managed medicines appropriately. Staff collected safety information and used it to improve the service. The service generally controlled infection risk well. Staff knew how to report patient safety incidents and could tell us about lessons learnt from them.
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Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent to carry out their role. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Key services were available seven days a week.
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Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their care. They provided emotional support to patients and those close to them.
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The service planned care to meet individual patient’s needs and made it easy for people to give feedback. People could access the service when they needed it.
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Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services.
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Staff were overwhelmingly positive about the culture of the service. Staff were proud to work for the organisation and were committed to supporting their colleagues and meeting the needs of their patients. Managers promoted a positive culture where staff were valued and respected. Staff were supported and empowered by managers to raise concerns and suggestions for improvement.
However, we also found the following issues that the service provider needs to improve:
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The risk register did not always highlight when the risks were last reviewed. Although we noted that the risk register was reviewed at the governance meeting. Following the inspection, the provider submitted an updated risk register which showed the issue had been addressed, and the updated risk register included the last review date.
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Not all of the staff we spoke with were able to articulate some of the national and professional guidelines that influenced their practice.
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We found an expired medicine and some out of date consumable items in the first aid box.
Following this inspection, we told the provider that they should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Nigel Acheson
Deputy Chief Inspector of Hospitals (London and the South East)