MSI Reproductive Choices Local Treatment Centre - Maidstone

Updated 9 October 2018

Marie Stopes International (MSI) Maidstone (MSI Maidstone) opened in 2001 and is part of the provider group Marie Stopes International (MSI). The centre provides services to the local community and accepts referrals from outside this area. The current registered manager has been in post since 2016.

MSI Maidstone provides consultations, ultrasound scans, medical and surgical termination of pregnancy, and counselling for patients who use the service. Other services offered are long acting reversible contraception (LARC), sexually transmitted infection testing (STI) and screening and vasectomy performed under local anaesthetic.

The service offers termination of pregnancy by surgical or medical methods. The centre offers early medical and medical termination up to nine weeks plus four days gestation and surgical termination of pregnancy is carried out up to 14 weeks gestation. Surgical termination of pregnancy is performed under ‘conscious sedation’, by vacuum aspiration or dilatation and evacuation or no anaesthetic according to patient choice.

Updated 9 October 2018

Marie Stopes International (MSI) Maidstone Centre is part of the provider Marie Stopes International UK (MSI UK). MSI UK is part of Marie Stopes International, a not for profit organisation that was founded in 1976 to provide a safe, legal abortion service following the Abortion Act 1967. The centre registered with the Care Quality Commission on 13 December 2010.

Maidstone centre offers early medical abortion (EMA), medical termination of pregnancy and surgical termination of pregnancy. Medical termination of pregnancy up to nine weeks plus four days gestation and surgical termination of pregnancy up to 14 weeks gestation. Surgical termination of pregnancy is carried out under ‘conscious sedation’ (a combination of medicines to help the patient relax during the procedure), or no anaesthetic according to patient choice. The centre also provides consultations, ultrasound scans, counselling, long acting reversible contraception and sexually transmitted infection screening services. In addition, the service also provides vasectomy (male sterilisation) under local anaesthetic.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 2 August 2018.

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 into account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

At our previous inspection on 25 July 2017 we found breaches in regulations and we served requirement notices in respect of:

• Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014 Safe care and treatment.
• Regulation 18 Health and Social Care Act (Regulated Activities) Regulations 2014 Notification of incidents.

At this inspection we checked to ensure that these breaches had been addressed.

We rated it as good overall.

Our key findings were as follows:

We found good practice in relation to:

• The service managed staffing effectively and services had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.

• The centre ensured that all patients first consultation was without anyone else present to ensure the patient was protected and allowed them to discuss information in a safe environment.

• Staff could explain the procedures for safeguarding children, young people and vulnerable adults. They knew the needs and vulnerabilities of children and young people using their service to enable prompt safeguarding referrals.

• Staff were non-judgmental and treated patients with kindness.

  However we also found:

• The centre had limited storage for waste. Waste was not separated into bulk storage bins in line with national guidance. All clinical waste was stored in a locked outside cupboard which we observed was extremely full and when opened bags fell out onto the floor posing a potential infection control risk to staff if items split.

• The environment was challenging throughout with regard to ensuring privacy and dignity for patients. This included consultation areas, waiting areas and recovery.

• Patients had to wait longer than the centres target to attend a surgical termination of pregnancy which is outside Royal College of Obstetricians and Gynaecologists (RCOG) guidance.

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.

Heidi Smoult

Deputy Chief Inspector of Hospitals

Updated 9 October 2018

Marie Stopes International (MSI) Maidstone Centre is part of the provider Marie Stopes International UK (MSI UK). The centre provides surgical termination of pregnancy up to 14 weeks gestation and medical termination of pregnancy and early medical termination of pregnancy up to nine weeks plus four days gestation.

The service also provides family planning services, including advice on contraceptive options. The service provides oral contraception and long acting reversible contraception (LARC) as well as male sterilisation (vasectomy). We rated this service as good in respect of all five domains and as good overall.