The Oaks Clinic is operated by Mediscan Healthcare Ltd. The service had two clinic rooms, though one was rented out, a waiting room and a toilet.
The service provides antenatal ultrasound scans, antenatal midwifery care, and gynaecology services. These were inspected under the diagnostic imaging core service, as the antenatal scans were the main activity the service provided.
We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 11 March 2020. We gave the provider short notice (24 hours) to ensure that the clinic was open for our inspection.
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.
Services we rate
We rated it as Requires improvement overall.
We found the following issues that the service provider needs to improve:
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Staff did not always use equipment and control measures to protect women, themselves and others from infection.
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The clinic did not store medicines securely at the time of our inspection. Following the inspection, storage of medicines was improved
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The service did not always provide care and treatment based on national guidance and best practice. Moreover, local guidance was not robust or embedded.
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Staff did not monitor the effectiveness of care and treatment.
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Leaders did not operate effective governance processes.
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Leaders and teams did not use systems to manage performance effectively. They did not always identify and escalate relevant risks and issues or identified actions to reduce their impact.
However, we also found the following areas of good practice:
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The equipment and premises were visibly clean.
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Staff completed and updated risk assessments for each patient and removed or minimised risks. Despite a lack of formal processes, staff were able to identify and act upon women at risk of deterioration.
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Staff kept detailed records of women’s care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.
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The registered manager and clinic manager worked together as a team to benefit women. They supported each other to provide good care.
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Staff treated women with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
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The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care.
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People could access the service when they needed it and received the right care promptly.
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, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected The Oaks Clinic. Details are at the end of the report.
Heidi Smoult
Deputy Chief Inspector of Hospitals (Central)