Archived: Verulam Clinic

Updated 22 January 2019

Verulam Clinic is an independent private diagnostic service based in St. Albans, Hertfordshire, and is operated by Verulam Clinic Limited. Verulam Clinic was established eight years ago. It provides diagnostic pregnancy and fertility imaging services (ultrasound scans) to self-funded women, aged 18 years and above, in St Albans and the surrounding areas. All ultrasound scans performed at Verulam Clinic are in addition to those provided through the NHS.

Verulam Clinic was initially established to offer nuchal translucency ultrasound screening, which was not available through the NHS at the time. Since this, the service evolved and now offers:

• Early pregnancy scans.

• Fertility scans.

• Growth and reassurance scans.

• Gynaecology scans.

Verulam Clinic no longer offers nuchal translucency scans as these are now routinely offered on the NHS.

The service has had a registered manager in post since registering with the CQC in 2011. Verulam Clinic had been previously inspected in November 2013 and was compliant in three of the five areas inspected. They were not compliant in complaints or requirements relating to workers. A follow-up inspection was undertaken in July 2014 and Verulam Clinic now met the standards for complaints but remained uncompliant with the requirements relating to workers.

Verulam Clinic is registered with the CQC to undertake the regulated activity of diagnostic and screening procedures.

Updated 22 January 2019

Verulam Clinic is operated by Verulam Clinic Limited. The service provides diagnostic pregnancy and fertility imaging services (ultrasound scans) to self-funded women in St Albans and the surrounding areas.

The service also offers additional services, which are not included in their regulated activity. This includes complementary health treatments and small group classes to couples, mothers, and babies.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 5 December 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 account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

We have not previously rated this service. At this inspection in December 2018, we rated the service as good overall.

We found areas of good practice:

• Staff were caring, kind and engaged well with women and their families.

• Services were planned in a way that met the needs of women and the local community. Women were offered a choice of appointments.

• Managers promoted a positive culture that supported and valued staff. Staff confirmed they felt respected and valued.

• The service used current evidence-based guidance and good practice standards to inform the delivery of care and treatment. Staff demonstrated a good understanding of the national legislation that affected their practice.

• Verulam Clinic had a clear vision and strategy for what they wanted to achieve, with quality and sustainability as the top priorities.

However, we found the following areas of practice that the service needed to improve:

• Staff did not receive mandatory training in key skills after their initial induction to the service. There was no oversight on what training the sonographers had completed at their substantive employer.

• While staff understood the need to protect people from abuse, they had not all completed safeguarding training at the required level to ensure they had the appropriate knowledge to do so. However, this was rectified after our inspection.

• Verulam Clinic did not have full oversight of the competencies, skills and capabilities of staff working for their service. There was no formal staff appraisal system in place at the time of our inspection. However, this was rectified after our inspection.

• We were not assured that the service always kept up-to-date with important national and statutory legislation.

• Informed consent was not appropriately gained from women who did not have English as their first language. However, this was rectified after our inspection.

• While the service generally had effective arrangements in place for identifying and recording risks, there was little evidence that these risks and their mitigating actions were discussed with the wider team.

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 one requirement notice that affected Verulam Clinic. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)

Updated 22 January 2019

The provision of ultrasound scanning services, which is classified under the diagnostic core service, was the only core service provided at Verulam Clinic. We rated the service as good overall because there were processes in place for the escalation of unexpected findings during ultrasound scans. Feedback was extremely positive. Appointments were scheduled to meet the needs of women who required their services, and the clinic manager had the appropriate skills and experience to manage the business.

However, there was not a renewable mandatory training programme or appraisal system in place for staff at the time of our inspection. Not all staff had completed safeguarding training at the required level; however, this was rectified after our inspection. Informed consent was not appropriately gained from women who did not have English as their first language; however, this was also rectified after our inspection.