BPAS - Bournemouth

We previously inspected this service in 2016, however it was not rated at that time. This was the first time we rated this service. We rated it as requires improvement because:

• The service did not always ensure the correct legal documentation was completed before surgical terminations.
• The service did not always provide care and treatment following current national guidance to ensure pregnancy remains were treated with respect.
• Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration. However, the service did not use a specific early warning system designed for children under the age of 16.
• Systems to safely prescribe, administer and record medicines were not always in line with national regulations and guidance. However, medicines were stored safely.
• The service provided mandatory training in key skills to all staff but not everyone had completed it.
• The service mostly managed patient safety incidents well. Staff recognised and reported incidents and near misses. Managers mostly investigated incidents and shared lessons learned with the whole team and the wider service.
• Waiting times from contact to consultation and treatment did not always meet standards in line with national standards and commissioning requirements.
• Leaders did not always operate effective governance processes. However, staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.
• Although leaders had the skills and abilities to run the service, they did not always have capacity to provide leadership as they had dual roles.
• Not all staff understood the organisation’s vision and strategy, and they were not all aware of the freedom to speak up guardian and how to contact them.

However:

• 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 and they knew how to apply it.
• The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.
• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix and gave bank staff a full induction.
• Staff kept detailed records of patients’ care and treatment. Records were clear, up to date, stored securely and easily available to all staff providing care.
• The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.
• 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, families and carers to minimise their distress. They understood patients' personal, cultural and religious needs.
• The service planned and provided care in a way that met the needs of local people and the communities served. The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.
• Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.