Background to this inspection
Updated
9 September 2019
Marie Stopes International Birmingham is operated by Marie Stopes International (MSI). The service opened in July 2012 and provides both medical and surgical termination of pregnancy. Surgical termination of pregnancy is provided up to 23 weeks six days and medical termination of pregnancy up to nine weeks and six days gestation.
The service is registered to provide the following regulated activities:
Termination of pregnancy
Surgical procedures
Family planning
Treatment of disease disorder or injury
Within the scope of these registered activities Marie Stopes International (MSI) Birmingham offers the following services to patients:
The centre is open five days a week, Monday to Friday 8am to 5pm with some Saturday clinics available during increased demand.
MSI provide services for private patients and NHS funded patients. Patients may self-refer or be referred by a health professional. Birmingham centre treat patients from across the country but predominantly from the local clinical commissioning groups (CCGs).
The service has two registered managers the most recent registered manager was registered on 7 March 2019 .
We last inspected Marie Stopes International Birmingham in July and August 2017; the inspection report was published in March 2018. The previous inspection was undertaken in June 2016 and was published in December 2016. This service was not rated because previously we did not have the legal powers to rate termination of pregnancy services. Following the previous inspection, we issued the provider with a warning notice in relation to Regulation12, Arrangements for the safe care and treatment and Regulation 17 Good governance. We also issued four requirement notices in relation to Regulation 11; Need for consent, Regulation 12, Arrangements for the safe care and treatment; Regulation 17 Good Governance; Regulation 20 Duty of candour. We followed these up during the inspection and found the service was now compliant with Regulations 11,12 and 20. We followed these up during the inspection and found the service was now compliant with Regulations 11,12 and 20. The requirements of both warning notices were met. However, the service was not fully compliant with all aspects of Regulation 17 and 18 and further improvements were required.
Updated
9 September 2019
Marie Stopes International Birmingham is operated by Marie Stopes International.
The service provides termination of pregnancy as a single speciality service; We inspected this service using our focused inspection methodology. We carried out unannounced visits to Marie Stopes International Birmingham Centre on 21 June 2019 and 4 July 2019.
Marie Stopes International (MSI) Birmingham Centre, 4 Arthur Road, Edgbaston, Birmingham has five early medical units (EMUs):
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Central Birmingham Early Medical Unit, Suite 204, 2nd Floor, Guildhall Building, Navigation Street, Birmingham,
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Handsworth Early Medical Unit, Soho Road Health Centre 247-251 Soho Road, Birmingham
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Sandwell Early Medical Unit, Glebe fields Health Centre, St Marks Road, Tipton.
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Walsall Early Medical Unit Rushall Medical Centre, 107 Lichfield Road, Walsall.
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Wolverhampton Early Medical Unit, Duncan Street Primary Care Centre, Blakenhall, Wolverhampton.(This was closed at the time of the inspection).
MSI Birmingham Centre (4 Arthur Road Birmingham), Central Birmingham, Handsworth, Sandwell, Walsall and Wolverhampton sites each hold a licence from the Department of Health (DH) to undertake termination of pregnancy services in accordance with The Abortion Act 1967. Services are provided predominantly to NHS-funded patients referred by local clinical commissioning groups, as well as to private patients.
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? This inspection focused on the safe and well led domains as a follow up to the previous inspection in July and August 2017 which was published in March 2018. Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate. We did not rate this service as this was a focused inspection and the service had not previously been rated.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
This was a focused inspection of a service which had not previously been rated and therefore was not rated.
We found the following areas of good practice:
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The service provided mandatory training in key skills to staff and most staff had completed it.
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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.
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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.
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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.
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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.
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The service used systems and processes to safely prescribe, administer and record medicines. Improvement was needed to ensure safe storage of some medicines.
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The service managed patient safety incidents well. Staff recognised and reported incidents and near misses.
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Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.
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Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.
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Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.
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All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them.
However, we also found the following issues that the service provider needs to improve:
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Whilst the premises were mainly observed to be visibly clean some areas within the treatment room were found to be dusty.
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We were not assured appropriate stock rotation and monitoring of all medical devices was in place. Not all patient medical equipment was checked as required to meet legal requirements and provide assurance of patients’ safety.
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Timely submission of notifications to external organisations was not always undertaken.
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, to help the service improve. We also issued the provider with two requirement notices that affected Marie Stopes Birmingham. Details are at the end of the report.
Nigel Acheson
Deputy Chief Inspector of Hospitals
Updated
9 September 2019
This was a focused inspection and was not rated.
Termination of pregnancy both surgically and medically was the main activity of the service alongside, family planning including long acting reversible contraception and sexual transmitted disease screening and treatment and counselling.
Staff were trained to provide advice to confirm pregnancy and its gestation and give patients information about treatment options dependant on their gestation. Appropriate procedures were in place to ensure the requirements of The Abortion Act 1967 and subsequent amendments were met.