Liverpool Skin Clinic

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed all 7 quality statements from this key question. Our rating for this key question has improved to requires improvement. There were gaps in governance and management systems, which prevented leaders from having full sight of information about risks, performance and outcomes. This limited opportunities to identify improvements to care. Audits were not always completed as planned and information sharing meetings were not consistently held amongst staff. We found evidence of policies not being reviewed or updated when passed their review date. Leaders and staff delivered care that was safe, integrated and person-centred.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Clinical leader identified risks to delivering the service’s strategy. We were told that current challenges of the service included the current infrastructure and staffing. Blueprints of a proposed new office space was shown to us while on site. We were also told that the service was in the process of hiring an aesthetics nurse. However, were told that this was communicated to the rest of team informally.

The service’s processes did not support staff and leaders to always ensure progress is monitored and reviewed against delivery of the strategy. The service could not provide evidence of regular meeting minutes of shared information amongst staff.

Staff shared that they did not have any concerns about the qualifications and experience of the clinical lead.

The service had a recruitment policy which was passed its review date, it stated relevant employment checks to be carried out but no predefined timeframes for Disclosure and Barring Service (DBS) certificate renewal. The hair surgeon had recently carried out her professional revalidation. Pre-employment checks were carried out for the head technician and clinic manager to establish they had relevant experience required for their roles.

Staff told us the clinic fostered an open culture as they were a small team. The hair surgeon, who was the clinic owner, told us staff had not raised any freedom to speak up concerns with her.

The service did not have a freedom to speak up policy however, there was a whistleblowing policy which was passed its review date.

We spoke to clinic staff who did not raise any concerns regarding equality. diversity and inclusion. They told us they were confident to raise concerns if they felt there was a need.

The service only employed 2 members of staff plus the provider. We saw that appropriate recruitment training was in place and the service had no concerns raised regarding equality, diversity and inclusion.

Staff told us that there was the service had a business continuity plan. It was acknowledged that governance meetings were not had as often as they should be held.

The service’s systems to manage performance and risks to the quality of the service were ineffective. The service had several of its policies which were past their review date. Information in certain policies referenced other care providers as their authors. Audits were not being completed as planned. The service’s risk register was not reviewed and updated regularly. COSHH products were past their review dates.

We received positive feedback that after care instructions included when and how to seek care from other health partners.

Other partners who worked with the organisation told us they had no concerns raised with them regarding the service.

The service was registered with the Independent Sectors Complaints and Adjudication Service (ISCAS) and had a valid subscription.

Hair surgeon told us that she shared the rationale for a change in practice with staff. Updates in her practice came from evidence she received from attending professional conferences and scientific journals. An example was given regarding medication which was now recommended for a year post hair transplant which had been shown to improve hair growth.

The service had a training policy which was in date. There was an opportunity for staff to take external additional training if they wished. The majority of training was provided in house by the surgeon or through an online platform. However, not all to staff were up to date with the training required.

Outcomes and impact of improvement measures were not always effectively monitored e.g. from recall alerts. However, service measured outcome of patients’ treatment via pre and post pictures.