20 February 2020
During a routine inspection
We carried out an announced comprehensive inspection at Shropshire Skin Clinic as part of our inspection programme and to provide the service with a rating. 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.
Shropshire Skin Clinic is based in Much Wenlock, Shropshire and provides a dermatology service to NHS patients within Telford and Wrekin, Shropshire and Powys. The Clinic provides services from The Lodge, Farley Road, Much Wenlock, Shropshire TF13 6NB and also has another registered location known as St Michaels Clinic in Shrewsbury, Shropshire.
The 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 and of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Shropshire Skin Clinic provides a limited range of non-surgical cosmetic interventions, for example botulinum toxin injections which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.
As a provider of Independent Healthcare, the service is able to offer a private dermatological service to patients within those areas offered to the NHS and beyond those geographical boundaries.
The service is managed from the provider’s main site at St Michael’s Skin Clinic, in Shrewsbury, Shropshire. The directors of the company are Dr Stephen Murdoch and Mrs Alison Murdoch.
Dr Stephen Murdoch 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.
In preparation for the inspection, the service had been sent comment cards and a collection box from CQC and had encouraged patients to fill these in prior to the inspection. We received a total of 14 completed comment cards which, included patients who had received diagnosis or treatment. Following the inspection and with the consent of patients, we also telephoned and spoke with two patients and a close relative that had accompanied their family member at the clinic for diagnosis and treatment. Feedback from comment cards and telephone discussions were very complimentary about the service and the care and treatment received. Patients spoke highly of the service and described staff as professional, attentive, friendly, caring, thoughtful and efficient.
Our key findings were :
- The service had clearly defined processes and systems in place to keep people safe and safeguarded from abuse.
- There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events, incidents and complaints.
- There were effective arrangements in place for monitoring and managing risk.
- Staff had received essential training in safe working practices.
- The provider had effective recruitment procedures in place to ensure staff were suitable for their role.
- Patients received effective care that met their needs, kept them safe and protected them from avoidable harm.
- The premises were clean, well maintained and well equipped to treat patients and meet their needs.
- Patients were provided with detailed information about any proposed treatment and costs where applicable, which enabled them to make an informed decision.
- Patients were offered convenient, timely and flexible appointments.
- Patients told us staff involved them in their care and treatment and treated them with compassion, kindness, dignity and respect.
- Written arrangements were in place between the service and the local hospital for transferring the care of patients with a cancer diagnosis.
- The service reviewed the effectiveness and appropriateness of the care provided.
- There were clear responsibilities, roles and systems for accountability to support good governance and management that assured the delivery of high-quality care and treatment.
The areas where the provider should make improvements are:
- Consider developing a lone working policy and risk assessment.
- Ensure safety checks carried out on the defibrillator also include checks on expiry dates of defibrillator pads.
- Improve the monitoring of vaccine fridge temperature checks.
- Develop a structured programme of structured quality improvement activity.
Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care