Background to this inspection
Updated
11 November 2019
Marie Stopes International (MSI) Leeds Centre is part of the provider group Marie Stopes International, a not for profit organisation that was founded in 1976.
MSI Leeds Centre opened in its current location in 2006. It is a private single specialty service in Leeds, West Yorkshire. The centre primarily serves the communities of Leeds, Bradford, Wakefield, North Yorkshire and York, Huddersfield, Calderdale and North Kirklees. It also accepts patient referrals from outside these areas.
The centre has had a registered manager in post since May 2013.
MSI Leeds Centre is contracted by Airedale, Wharfedale and Craven, Bradford City, Bradford District, Hambleton, Richmondshire and Whitby, Harrogate and Rural District, Scarborough and Ryedale, Vale of York, Calderdale, Greater Huddersfield, Leeds, North Kirklees, North Lincolnshire and Wakefield Clinical Commissioning Groups (CCGs) to provide a termination of pregnancy services for the patients of West Yorkshire and surrounding areas. The centre also accepts patient referrals from around the UK and abroad. The service receives referrals from general practitioners (GPs), hospitals, family planning services and another independent providers. Patients are also able to self-refer. The service treats adults and young people aged 13 and above. The number of young people aged under 16 forms 0.2% of the patients treated at the centre.
MSI Leeds Centre also manages six early medical unit (EMU) satellite clinics located in the community, where early medical abortion (EMA) and consultations in the early stages of pregnancy are provided in a private consultation room. The MSI Leeds Centre also provides medical termination of pregnancy up to nine weeks and six days gestation at the main Leeds centre. They provide a weekly vasectomy (male sterilisation) service at the main Leeds centre and three satellite units. The units each provide a treatment room and a recovery area with a reclining chair.
The service provides surgical termination of pregnancy (Surgical ToP) procedures up to 18 weeks and six days gestation, as well as early medical abortion (EMA) up to nine weeks gestation and medical termination of pregnancy up to nine weeks and six days. Surgical ToP involves vacuum aspiration or dilatation and evacuation and is carried out under general anaesthetic, sedation, or no anaesthesia according to patient choice or needs. EMA and medical termination of pregnancy involves a woman taking two doses of medicine, mifepristone and misoprostol, to terminate a pregnancy. These can be taken simultaneously or at a prescribed interval depending on patient choice or needs. The service also provides consultations, ultrasound scans, contraception advice and administration including fitting of long acting reversible contraception (LARC) and screening services for sexually transmitted infections.
The service is registered as a single speciality service and provides the following regulated activities:
• Termination of pregnancy
• Family planning
• Treatment of disease, disorder or injury
• Surgical procedures
• Diagnostic and screening procedures
The service had two registered managers in post during the time of our inspection. One registered manager is the operations manager and has been in post since March 2018 and the other registered manager is the regional manager who has been in post since June 2017. The clinical services matron has been in post since May 2019. The operations manager and clinical services matron provide dedicated on-site managerial support for operational and clinical issues.
Updated
11 November 2019
Marie Stopes International (MSI) Leeds Centre is part of the provider group Marie Stopes International, a not for profit organisation that was founded in 1976. Facilities at the centre included a treatment room, three consulting rooms, ultrasound facilities, three waiting rooms and a recovery room with eight reclining chairs.
The service provided termination of pregnancy by either surgical termination of pregnancy (surgical ToP) procedures up to 18 weeks and six days gestation, early medical abortion (EMA) up to 63 days (nine weeks) gestation or medical termination of pregnancy up to nine weeks and six days. Surgical ToP involved vacuum aspiration or dilatation and evacuation and was carried out under general anaesthetic, sedation, or no anaesthesia for up to 18 weeks and six days according to patient choice or needs. EMA and medical termination of pregnancy involved a woman taking two doses of medicine, mifepristone and misoprostol, to terminate a pregnancy. These could be taken simultaneously or at a prescribed interval depending on patient choice or needs. The service also provided consultations, ultrasound scans, contraception advice and administation, including fitting of long acting reversible contraception (LARC) and screening services for sexually transmitted infections. There was also a vasectomy service (male sterilisation) provided at the centre.
MSI Leeds Centre also managed six early medical unit (EMU) satellite clinics located in the community, where EMA and consultations in the early stages of pregnancy were provided in a private consultation room. The MSI Leeds Centre also provided a weekly vasectomy service at the MSI Leeds centre and three satellite units. The units provided a treatment room and a recovery area with a reclining chair.
We inspected this service using our comprehensive inspection methodology. We carried out two unannounced visits on 16 and 18 July 2019.
To get to the heart of patients’ experiences of care and treatment, we asked 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.
At our previous inspection on 13, 14 and 28 July 2017 we found a breach in regulation and we served a requirement notice in respect of:
Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014 Safe care and treatment.
At this inspection we checked that actions had been implemented to address the breach and meet the regulation. We found that improvements had been made in mandatory training compliance and staff competencies, staff survey provision, participation and results, and completion and monitoring of termination of pregnancy early warning scores (TEWS) documentation.
Services we rate
We rated this service as Good overall.
We found good practice in relation to:
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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. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
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Staff provided good care and treatment and gave patients pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent.
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Staff treated patients with compassion and kindness, respected their privacy and dignity and took account of their individual needs. They provided emotional support to patients.
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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 on weekdays. Although there were sometimes waiting lists, management ensured these did not impact negatively on treatment options for patients.
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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 respected, supported and valued. Staff throughout the service were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually. Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff were actively encouraged to speak up and raise concerns.
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There was inclusive and effective leadership at all levels. Leaders demonstrated the experience, capacity and capability needed to deliver sustainable care.
We also found some areas of outstanding practice:
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A systematic approach was in place to work with other organisations to improve care outcomes. The service sought to influence care within its sector positively and demonstrated commitment to seeking out new models of care to influence and educate future patients, local partnerships and wider external stakeholders.
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Leadership, governance and culture were used to drive and improve the delivery of holistic person-centred care. There was strong collaboration, teamwork and support and a common focus on improving the quality and sustainability of care and patient experiences.
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Comprehensive and successful leadership strategies were in place to develop the desired culture. Leaders understood issues, challenges and priorities in their service, and beyond.
Ann Ford
Deputy Chief Inspector of Hospitals
Updated
11 November 2019
Marie Stopes International (MSI) Leeds Centre provided surgical termination of pregnancy up to 18 weeks and six days gestation, early medical abortion (EMA) up to nine weeks gestation and medical termination of pregnancy up to nine weeks and six days gestation. The centre also had seven satellite clinics in the community, six of them providing medical termination up to nine weeks and four days gestation. The service also provided contraception advice including the fitting of long acting reversible contraception (LARC) as well as vasectomy (male sterilisation treatment).
We rated this service as good overall.
Safe, effective, caring, and responsive were all rated as good. Well led was rated as outstanding.