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Archived: Marie Stopes International Birmingham

The provider of this service changed - see old profile

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Inspection report

Date of Inspection: 10 December 2013
Date of Publication: 10 January 2014
Inspection Report published 10 January 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 10 December 2013, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with staff, reviewed information given to us by the provider, were accompanied by a pharmacist and reviewed information sent to us by commissioners of services.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

People attending the clinic on the day of our visit were complimentary about the service. One person told us, “I wasn’t very happy before I came here today, I was very nervous and distressed but now I feel relieved”.

We did not observe consultations or pre-treatment checks on the day of our visit. We spoke with staff about the process that was followed. They told us that many women chose to have a telephone consultation with staff in the call centre. Consultation included an assessment of people's past and present medical history, social circumstances, medication and any known health risks. If they decided to proceed with treatment, an appointment was then booked for them to attend a centre of their choice. We were told that this could be arranged from within a few days or up to a number of weeks, depending on each woman's circumstances.

People’s records were held electronically, with some information held in paper format. We looked at one person’s electronic records and at 10 paper records. The electronic records showed that the patient's medical history was recorded and the reason for the patient's choice of treatment was clearly outlined. It was evident that the risks and benefits associated with the treatment of choice had been discussed with the patient and documented.

We were told that consideration was given to the distance women had to travel to the clinic. Some women travelled long distances to receive treatment at the clinic. There were arrangements in place to cater for these people, including a quiet room where they could relax. This area had been introduced since our last visit to the clinic.

People's privacy and dignity were respected. In the waiting room we observed that people were approached by a member of staff who introduced themselves and escorted them to one of the consulting rooms. All consulting rooms were private and had 'engaged' signs in place when occupied. Each room had a curtain that could be drawn around the couch if an examination was required. One person told us, “I have been treated with respect and dignity”.

When women attended the clinic they had further explanation and exploration of their treatment options. They received a range of pre-treatment tests, including an ultrasound scan. There was also a discussion about the reason for them requesting a termination, which is a legal requirement. The treatment then had to be authorised by two medical practitioners. This was sometimes done remotely, depending on the availability of medical staff. All authorising doctors had remote access to the woman's electronic medical record which was completed by the admitting nurse/ health care assistant. We looked at a sample of medical records and saw that the necessary medical authorisation had been obtained before any treatment took place. In some instances, neither of the authorising doctors had seen the person. The provider may find it useful to note that it is considered good practice that one of the two certifying doctors has seen the person, though this is not a legal requirement.

We were informed that anyone under the age of 18 would always be seen by one of the certifying doctors. We looked at the records for two people under 18 and found they had both been seen by a doctor.

We saw evidence to show risks were assessed and discussed with people who used the service. One member of staff discussed a recent situation when the centre been unable to provide treatment because of the associated health risks. The member of staff explained that following assessment the person was referred to an alternative service to make sure the risk was managed appropriately.

During our visit we spoke with one of the medical staff. They told us that before any surgical termination took place they had sufficient time to review the person’ records and to meet with them to discuss any concerns if needed.

We noted that surgical safety checklists had been completed for all people who underwent surgery. These checklist