The Old Forge at Danbury is operated by Woodford Medical Limited. The service has no overnight beds. Facilities include three adjacent buildings on the same site known as the clinic, the cottage and the forge. The forge and the cottage are only used for treatments not within the scope of regulated activity. The cottage has two treatment rooms, one reception and one staff toilet. The Forge has two treatment rooms, one assessment room, one reception, one waiting room and one toilet area for patients. The clinic building was where all medical treatments by the doctors, surgeon and nurse are undertaken. It has two treatment rooms, one waiting room and one toilet for patients and one reception area. On the first floor there are two rooms for administration with a kitchen and toilet for staff.
The service provides cosmetic minor surgery and day attender treatments for fillers, surgical thread lifts, sclerotherapy (injection to improve spider veins on the legs), fat dissolving treatments and intense pulsed light (IPL) laser. During our inspection we inspected the procedures the service has registered with the care quality commission (CQC) which are, minor surgery, and sclerotherapy services.
We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 22 October 2019 and followed up with telephone calls to six patients who consented to discuss their experience with us.
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.
The main service provided by this clinic was minor surgery which includes the removal of lumps or moles, eye lid surgery and sclerotherapy.
All non-invasive treatments were not inspected as they are outside of the regulated activity registered with the CQC.
Services we rate
We found safe, effective, caring, responsive and well led were all good. This led to a rating of good overall.
We found areas of good practice:
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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. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents. Staff monitored patient safety information.
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Staff provided good care and treatment, gave patients enough to drink, and gave them pain relief when they needed it. The manager and two clinicians monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to information. However, not all guidelines were supported by references
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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 conditions.
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The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
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The two doctors ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and how to apply in their work. The service had no clear strategy currently for future development. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and all staff were committed to improving services continually.
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Heidi Smoult
Deputy Chief Inspector of Hospitals (Central)