Cheshire Hair Transplant Clinic Limited

Independent Healthcare Org · North West

Overall Rating
Inadequate Last inspected 20 June 2023
Domain Ratings
Safe
Inadequate
Effective
Inadequate
Caring
Not Yet Rated
Responsive
Requires Improvement
Well-led
Inadequate

View Full CQC Report

8 must-do actions
4 should-do actions

Must-Do Actions (8)

Legal requirements based on regulation breaches identified during inspection.

Must Do
Safe
The service must ensure they have systems and processes in place to meet the requirements of The Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and any other relevant guidance to reduce the risk to patients from infection.
Regulation 12(2)(h)
The service did not always control infection risk well. The service did not have a mandatory training schedule aligned to the UK core skills for health framework. The log did not show specifically which areas were cleaned or if they were cleaned before and after the procedure. The registered manager …
Must Do
Safe
The service must ensure that medicines are prescribed, administered, recorded, and stored safely.
Regulation 12(2)(g)
The service did not always use systems and processes to safely prescribe, administer, record and store medicines. Staff did not always store medicines safely. The temperatures they recorded often significantly exceeded the expected range of a medicine’s fridge, 2 to 8 degrees centigrade. Staff did not always prescribe and record …
Must Do
Safe
The service must ensure that staff complete training in key areas, including safeguarding, to a level appropriate for their role and that staff can correctly identify and report abuse.
Regulation 12(2)(c)
Some staff did not complete training in key skills including safeguarding. The service did not provide mandatory training in key skills to all staff and make sure everyone completed it. Some staff had completed little or no mandatory training. Staff did not always receive training on how to recognise and …
Must Do
Safe
The service must ensure staff assess, record, and mitigate the risks to patients.
Regulation 12(1)(2)
Staff did not always complete and update risk assessments for each patient, identify and remove risk and act upon patients at risk of deterioration. Two of the five records we inspected did not include a health questionnaire and consultation notes showed limited evidence of complete or consistent risk assessments. There …
Must Do
Well-led
The service must ensure that appropriate policies, systems and processes are in place to govern the service, support staff to do their roles safely and manage the risks to patients.
Regulation 17(2)(a)(b)
The service did not always have up to date and accurate policies to govern the service and guide staff to deliver the service safely and did not ensure staff read them. Staff did not follow up to date policies to plan and deliver high quality care according to best practice …
Must Do
Well-led
The service must ensure staff keep complete and accurate patient records and store them safely.
Regulation 17(1)(2)(c)
Staff did not always keep detailed, clear and up to date records and not all staff could access them. Patient notes were not always comprehensive or complete. None of the records were comprehensive and clear. Two of the five records we inspected did not include a patient health questionnaire. One …
Must Do
Well-led
The service must ensure that robust recruitment processes are in place to ensure staff are ‘fit and proper’ to fulfil their role.
Regulation 17(2)(d)
The service did not operate robust recruitment processes for all staff and managers did not always check staff were competent for their roles. Managers did not provide staff with an induction and did not always check staff had the knowledge, skills, and experience to fulfil their role. The provider could …
Must Do
Effective
The service must ensure patients receive all the information they need, at the right time and from the right staff, to make informed decisions about their treatment.
Regulation 11(1)
The provider could not evidence staff obtained informed consent from patients in line with national guidance. There was a risk patients did not receive all the information they needed, at the right time and from the right staff, to make informed decisions about their treatment. There was no formal process …

Should-Do Actions (4)

Recommended improvements to enhance service quality.

Should Do
Well-led
The service should ensure effective systems are in place to monitor the effectiveness of the service and drive improvements.
Regulation 17(2)(a)
Should Do
Well-led
The service should ensure staff receive an induction, supervision, and appraisal to support them to perform their role and identify training needs.
Regulation 18(2)(a)
Should Do
Responsive
The service should consider introducing processes to ensure the service is accessible to all patients, including those with protected characteristics.
Should Do
Responsive
The service should consider subscribing to an independent complaints review body.
Location Details
CQC ID: 1-11024378236
Local Authority: Cheshire East
Region: North West
Inspection Report
Type: Comprehensive inspection
Date: 20 June 2023
Rating: Inadequate
Actions: 8 must-do , 4 should-do
AI-extracted 17 Feb 2026