CRGH City

Updated 4 March 2022

City Fertility Limited is operated by City Fertility Limited. The service provides surgical procedures but has no overnight stays. The hysteroscopy and Hysterosalpingo Contrast Sonography (HyCoSy) are the only two services subject to regulation by the Care Quality Commission (CQC). The service is also licensed by the Human Fertilisation and Embryology Authority (HFEA).

We inspected hysteroscopy, which treats conditions of the womb such as fibroids and polyps and HyCoSy which is an investigation of the fallopian tube. These procedures are done as a part of fertility treatment and are self-funding.

From January 2021 to December 2021 the service provided 64 hysteroscopy and 48 HyCoSy procedures.

The service has a registered manager.

The main service regulated by the CQC was surgery. Where our findings on diagnostic imaging – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service.

Updated 4 March 2022

We have not previously rated the service. We rated it as good because:

• 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.
• Staff provided good care and treatment and gave them 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.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• 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 when they needed it and did not have to wait 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 respected, supported and valued. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

However:

• Staff gave inconsistent information on whom to inform if they had any safeguarding children and vulnerable adults concerns.
• Medicines management audits were not completed frequently, and we found expired medication present.
• The standard operating procedure (SOP) for HyCoSy did not refer to the specific professional guidance and version used to inform the SOP.

Updated 4 March 2022

Our rating of this service stayed the same. We rated it as good because:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse.
• The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
• Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.
• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

However:

• The standard operating procedure (SOP) for HyCoSy did not refer to the specific professional guidance and version used to inform the SOP.

Updated 4 March 2022

We have not previously rated the service. We rated it as good because:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse.
• The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment visibly clean.
• Doctors, nurses and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.
• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

However:

• Staff gave inconsistent information on whom to inform if they had any safeguarding children and vulnerable adults concerns.
• Medicines management audits were not completed frequently, and we found expired medication present.

Diagnostic imaging is the smaller proportion of the clinic’s activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.