Our rating of this location went down. We rated it as inadequate because:
The service did not provide mandatory training in key skills. Staff did not have the appropriate level of training on how to recognise and report abuse. The service did not control infection risk well and the clinic was visibly dirty. The design, maintenance and use of facilities, premises and equipment did not always keep people safe. Staff did not always complete relevant risk assessments for each woman using the service. Staff did not always keep detailed records of women who used the service, care and procedures. The service did not have a clear process for the management of incidents. Staff were not trained in how to recognise and report incidents and near misses.
The service did not always provide staff with access to the most up-to-date best practice guidelines and managers did not check to make sure staff followed guidance. The service did not collect any outcome data or monitor the effectiveness of care. The service did not make sure staff were competent for their roles. Staff did not always give women who used the service practical support and advice to lead healthier lives. Staff did not receive training in how to support women to make informed decisions about their care and did not always understand how to appropriately gain women's consent for their care and treatment.
Staff did not always respect the privacy and dignity of service users. Staff were not trained on how to provide emotional support to women who were distressed. Staff did not always support women, families and carers to understand their condition and make decisions about their care and treatment.
The service was not always inclusive and did not always take account of women using the service individual needs and preferences. Reasonable adjustments were not always made to help women access services. Lessons learnt from complaints were not always identified and actions were not always taken to prevent similar complaints happening.
Leaders did not always demonstrate that they had the skills and abilities to run the service. Leaders did not operate effective governance processes. Staff were not always clear about their roles and accountabilities. Leaders and staff did not always discuss and learn from the performance of the service. Leaders did not always have systems to manage performance effectively. They did not always identify and escalate relevant risks and issues and identify actions to reduce their impact. Active engagement with staff, service users and external stakeholders and organisations to plan and manage services was limited. We saw no examples of continuous learning and improvement of the service.
However:
The service had enough staff to provide care.
Staff treated women with compassion and kindness, and we observed friendly and caring interactions between staff and women.
People could access the service when they needed to
Staff felt respected, supported and valued.