• Hospital
  • Independent hospital

Archived: BPAS - Tottenham

Lordship Lane Clinic, 239 Lordship Lane, London, N17 6AA 0345 730 4030

Provided and run by:
British Pregnancy Advisory Service

All Inspections

4 May 2016

During a routine inspection

Is the service safe?

  • Authorisation for the supply and administration of medicines under patient group directions (PGDs) was not carried out or documented in line with national or local guidelines.
  • Incidents, including those with a potential to cause harm to patients or staff, were not always reported.
  • Staff did not receive prompt feedback from incidents to reduce the risk of recurrence.
  • The approach to anticipating managing day-to-day risks to people who used the service was reactive rather than pro-active, and tended to be led at a regional or corporate level. This meant that opportunities to prevent or minimise harm could be missed.
  • National specifications for infection prevention and control were not adhered to. In particular, requirements for cleaning schedules, and checklists; and clear separation of clean and dirty activities and equipment.
  • There were reliable systems, processes and practices in place to keep people safeguarded from abuse.
  • There was a specialist placement team to source appointments within the NHS for patients who were not suitable for treatment at BPAS on medical grounds.
  • Medicines were safely ordered, supplied, and stored in accordance with manufacturers’ instructions, and administered only when they had been prescribed for a named client.
  • Records were securely stored, well maintained and completed with clear dates, times and designation of the person documenting.
  • Safety and maintenance checks were generally carried out on equipment in accordance with local and national requirements.
  • There were sufficient numbers of suitably trained staff available to care for patients.
  • Arrangements were in place to manage emergencies and transfer patients to another health care provider where needed and were known to all staff.

Is the service effective?

  • Care took account of national best practice guidelines.
  • The exception was the use of simultaneous administration of abortifacient drugs for early medical abortion (EMA), which is outside of current Royal College of Obstetrician and Gynaecologist (RCOG) guidance. However; we saw that a structured governance system was in place and had been followed to introduce this treatment option.
  • The complication rate for simultaneous administration was approximately double that for medical abortion treatment when medicines were administered separately.
  • Policies were accessible for all staff and were kept up to date.
  • Patients were offered pain relief, preventative antibiotic treatments and post-abortion contraceptives.
  • Staff had an annual appraisal.
  • Counselling staff participated in group counselling supervision.
  • The BPAS Aftercare Line, a telephone service, was accessible to patients 24 hours a day and for seven days a week.

Is the service caring?

  • Staff were caring and compassionate and treated patients with dignity, understanding, and respect.
  • Patients gave consistently positive feedback and described the staff as ‘kind, warm, and professional’.
  • During the initial assessment, nurses and midwives explained to patients all the available methods for termination of pregnancy that were appropriate and safe. Staff considered gestational age and other clinical needs whilst suggesting these options.
  • Patients considering termination of pregnancy had access to pre and post termination counselling, with no time limits attached, but were not obliged to use the counselling service.

Is the service responsive?

  • Patients could book appointments through the BPAS telephone booking service which was open 24 hours a day throughout the year. This also enabled patients to choose the location and time they attended.
  • Patients were able to attend other local BPAS clinics for treatment if Tottenham was closed.
  • BPAS Tottenham did not offer surgical treatment. Patients who chose this option would be referred to treatment at one of two BPAS treatment units in London.
  • There was a fast track appointment system for patients with a higher gestational age or complex needs.
  • A professional interpreter service was available to enable staff to communicate with patients whose first language was not English.
  • Patients were provided with information to help them to make decisions.

Is the service well-led ?

  • There were effective governance arrangements to manage risk and quality. However, local risks were not always identified or acted upon by people with the authority to do so.
  • Staff felt supported by the treatment unit and regional managers, and considered the leadership and visibility of senior managers was good.
  • The culture within the service was caring, non-judgemental and supportive to patients.
  • Staff spoke positively about the high quality care and services they provided for patients and were proud to work for BPAS.

15 November 2013

During a routine inspection

People told us before they had any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. One person told us "I had options and was asked to sign the consent form before I could have treatment".

Care and treatment was planned and delivered in line with their individual care plan as peoples needs were assessed prior to any treatment. People who used the service were given information about the service they would receive and after care they could access through calling a 24 hour number.

There was clear guidance about how people who used the service were protected from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening through staff training. Staff gave people the opportunity to talk in private about any concerns they had.

We found people were treated by staff who were supported to deliver care and treatment safely. Staff had a comprehensive induction to ensure they are well trained to deliver the service the people need. We found they were encouraged to obtain further relevant qualifications through professional development.

People were asked for their views about their care and treatment and these views were acted on. People were positive about the service. One person said "they listened to every thing I've said and have been patient".

9 January 2013

During a routine inspection

The people who use the service told us that the staff were helpful and the information they received enabled them to make their own choices and decisions. They also told us that staff gave them sufficient time to make their decisions and did not rush them. One person said that staff were 'Absolutely fantastic, they made me feel very much at ease'.

All staff had received safeguarding training, although two new members of staff had yet to receive specific training in safeguarding young people. There were policies and procedures in place for safeguarding.

People who use the service told us that their privacy and dignity was maintained. People told us that staff were non judgemental and they listened. All consultations are carried out in individual consulting rooms.

Staff told us they were well supported by their manager and that communication was good within the team. Staff also told us they received regular training. People who use the service said the staff were very professional and knowledgeable.