The Gynaecology Ultrasound Centre is operated by The Gynaecology Ultrasound Centre Limited. Facilities include two clinical rooms for examinations and ultrasound scanning. There is a changing cubicle and a clinical storage area in each room.

The Gynaecology Ultrasound Centre is a standalone service and provides a private clinical and diagnostic service for women with concerns about their gynaecological health, including early pregnancy. It does not provide a service to NHS patients. The centre offers transvaginal and transabdominal scanning as well as two and three-dimensional scans where appropriate. Most women are referred by their consultant or GP. It provides gynaecological diagnostic services to women and children under 18 years of age.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 22 January 2019.

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? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this hospital was diagnostic imaging.

Services we rate

We rated this service as Requires improvement overall.

We found areas of practice that were inadequate in this service:

• Systems for the management and referral of safeguarding concerns did not reflect current best practice in relation to safeguarding adults.

• The providers statement of purpose did not reflect its services for patients under 18 years of age.

• At the time of inspection, the provider did not have a safeguarding children policy in place, despite treating patients under the age of 18.

• At the time of inspection, the service had no process in place to audit infection control measures, including hand hygiene and regular cleaning.

• The service did not follow best practice when storing medicines.

• At the time of inspection, the provider did not have a formal incident reporting mechanism in place which

• Policies, procedures and guidelines did not always reference current legislation, evidence-based care and treatment or best practice.

• The service did not always make sure staff were competent for their roles.

• Staff had not completed dementia or learning disability awareness training. The service planned and provided services in a way that met the needs of local people.

• Risk and audit were not embedded within the management of the service and there was a lack of overarching governance.

• The service did not have systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.

However, we found the following areas of good practice:

• The clinical environment was visibly clean and tidy and staff decontaminated ultrasound equipment after use.

• The service had sufficient staff to provide the right care and treatment.

• Recent audits demonstrated effective and safe practice.

• Staff were aware of the importance of gaining consent from patients before conducting any procedures.

• Staff worked well together to place the patients at the centre of service and ensure their comfort and satisfaction.

• Staff were supportive, caring and ensured patient’s privacy and dignity was maintained.

• The service planned and provided services in a way that met the needs of those who used the service.

• The manager promoted a positive culture that supported staff and created a sense of common purpose based on shared values.

• The service engaged well with patients and staff.

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, even though a regulation had not been breached, to help the service improve. We also issued the provider with two requirement notices that affected this service. Details are at the end of the report.

Prior to the publication of this report the provider provided evidence that it was in the process of addressing the concerns we had raised with them.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

People who use the service understood the treatment available to them. Most people were referred for gynaecological scans by a consultant or GP. The gynaecologists undertaking the scans discussed the findings with people and sent the results on the same day to the referring doctors. We spoke with two people who said that the service was "very well organised" and that the staff were "extremely knowledgeable."

People expressed their views about their care and treatment and the results of feedback showed that people were positive about the way their scan was explained.

There were effective systems in place to reduce the risk of infection following cleaning protocols and using disposable items.

Care and treatment was provided by staff that were appropriately qualified and kept themselves up-to–date with their professional development.

The provider regularly assessed the quality of its service and actively sought feedback from people attending the centre who all rated the service very highly.