The Care Quality Commission
  • Hospital
  • Independent hospital

Natural Look Clinic

Overall: Requires improvement read more about inspection ratings

104 Thorne Road, Doncaster, South Yorkshire, DN2 5BJ (01302) 760222

Provided and run by:
NLK Limited

All Inspections

15 October 2020

During an inspection looking at part of the service

The CQC carried out a responsive follow up inspection at Natural Look Clinic on the 15 October 2020. This inspection was undertaken following a notice served to the provider under section 31 of the Health and Social Care Act 2008. The section 31 notice was served in August 2020 and required the provider to immediately suspend the carrying out of any surgical procedures which require local anaesthetic or sedation on patients.

We undertook the inspection in October 2020 to see if improvements to the service had been made.

Natural Look Clinic is operated by NLK Limited.

The service provides pre-operative assessment and post-operative follow up, including wound care for surgical procedures in cosmetic surgery. On site operative surgical procedures include liposuction and fat transfer, breast augmentation with or without uplift, non-major breast reductions, hair transplant, upper lid blepharoplasty, pinnaplasty, labiaplasty, mini-abdominoplasty/small abdominoplasty and mini-facelift.

Documentation submitted to CQC by the provider stated that all procedures were carried out under local anaesthesia with conscious sedation.

The service is registered for the regulated activities of diagnostic and screening procedures, services in slimming clinics, surgical procedures and treatment of disease, disorder or injury.

Our rating of this service improved. We rated it as requires improvement overall because;

  • The service provided mandatory training in key skills to all staff. Mandatory training had been updated and new processes introduced. Clinical staff understood how to protect patients from abuse and work with other agencies to do so. Staff used equipment and control measures to protect patients, themselves and others from infection
  • The service had introduced new equipment and processes to monitor and record patients under conscious sedation and reduce their risk of deterioration. Additional training on identifying and acting on patients that may become unwell had been provided
  • The service was updating systems and processes to safely prescribe, administer, record and store medicines
  • The service had made changes to their senior team to strengthen leadership. New managers had the skills and abilities to run the service. Improvements had been made to governance processes throughout the organisation.

However;

  • We were unable to see if new policies and procedures had been implemented with patients and their records as no treatments had been undertaken since our last inspection
  • We were not assured that new policies and procedures had become embedded with staff. Training on new equipment had yet to be implemented and incorporated into policies
  • Not all non-clinical staff had received safeguarding training appropriate to their role
  • Gaps in documentation relating to medical staff practicing privileges were identified
  • Records of risks were not maintained, nor any actions taken to mitigate these risks

Following this inspection, we told the provider that it must take some actions to comply with the regulations.

12 August 2020

During an inspection looking at part of the service

The CQC carried out an urgent inspection at Natural Look Clinic in response to concerning information received.

This included concerns regarding treatment received by a patient including allegations that a patient lost a significant amount of blood during a procedure and there was a significant delay in contacting emergency services.

Further, it was alleged safety measures in place during the COVID-19 pandemic were not compliant with guidance.

Natural Look Clinic is operated by NLK Limited.

The service provides pre-operative assessment and post-operative follow up, including wound care for surgical procedures in cosmetic surgery. On site operative surgical procedures include liposuction and fat transfer, breast augmentation with or without uplift, non-major breast reductions, hair transplant, upper lid blepharoplasty, pinnaplasty, labiaplasty, mini-abdominoplasty/small abdominoplasty and mini-facelift.

Documentation submitted to CQC by the provider stated that all procedures were carried out under local anaesthesia with conscious sedation. Major surgical procedures are carried out at other registered establishments under practising privileges. Although, the service was registered for dental surgical procedures, these were not being carried out at the time of inspection.

We inspected this service using our focused inspection methodology. We carried out a short notice inspection on 12 August 2020.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this service went down. We rated it as Inadequate overall because:

  • Staff did not complete and update risk assessments for each patient and did not remove or minimise risks;

  • Staff did not identify and quickly act upon patients at risk of deterioration;

  • Staff did not keep detailed records of patients’ care and treatment. Records were not clear and up to date;

  • The service did not use systems and processes to safely prescribe and administer medicines;

  • The service did not manage patient safety incidents well;

  • Leaders did not have the skills and abilities to run the service;

  • Leaders did not understand and did not manage the priorities and issues the service faced;

  • Leaders did not operate effective governance processes throughout the service; and

  • Leaders and teams did not use systems to manage performance effectively.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements to help the service improve.

Sarah Dronsfield

Head of Hospital Inspection (North)

21 November 2019

During a routine inspection

Natural Look Clinic is operated by NLK Limited. The service has four day-case beds and an operating theatre.

The service provides cosmetic surgery and slimming clinics for adults. We inspected cosmetic surgery only. The business was currently seeking to engage a dentist and so hoped to begin providing this service soon. The provider also told us that the service intended to cancel its registration for services in slimming clinics, as it was not carrying out this regulated activity. Overall, the service provides a range of surgical and cosmetic procedures, with a focus on breast augmentation, under local anaesthetic or sedation, to fee-paying patients who are over 18 years old.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the premises on 21 November 2019.

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.

We rated this service as Good overall. We found good practice in relation to surgery:

  • 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. They managed medicines well. The service managed safety incidents well, learned lessons from them, and used this learning to improve the service.

  • Staff provided good care and treatment. They gave patients pain relief when they needed it. Managers 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 good information. Post-operative support was available seven days a week.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their procedures. They could describe how they would provide emotional support to patients, families, and carers if need be.

  • The service planned care to meet the needs of potential patients, 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.

  • 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 felt 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 staff, and all staff were committed to improving services continually.

We found an area of outstanding practice in surgery:

  • Although the service did not use any general anaesthetic, and its surgeons were qualified to administer sedation and/or local anaesthetic themselves, no surgery was performed without an anaesthetist.

We also found areas of practice that require improvement:

  • The service did not provide shower facilities for patients or staff.

  • Theatre scrubs were laundered by a local company between each usage. The service did not provide assurance that this met standards described by guidance from the Department of Health and Social Care for the decontamination of linen for health and social care management.

  • The service had not yet kept any formal records of its staff meetings or governance meetings.

Following this inspection, we told the provider that it 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.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

11, 12, 13 February 2014

During a routine inspection

Patients who used the service told us they were asked for their consent to treatment after a full explanation of the proposed procedures had been given to them. We found that the clinic had appropriate policies on consent and a consent form which covered all relevant areas.

Patients told us they were satisfied with the care they received. They also told us they were given clear information about the procedures being undertaken. We found that the patients were fully assessed, and treatment was planned and delivered in line with their individual needs.

Patients told us they were treated in a clean environment. We found that patients were protected from the risk of infection as there were effective systems in place to reduce the risk and spread of infection.

Patients we spoke with told us staff were competent in their job and knew what they were doing. We found that staff received an appropriate level of training and professional development.

Patients who used the service told us they knew who to contact if they wished to make a complaint. There was a complaints procedure in place and staff were aware of their responsibilities to report complaints so they could be formally investigated.