Beard Mill Clinic is operated by Dr Victoria Heath. The service provides antenatal ultrasound screening for pregnant women, from 6 weeks up to full term. It is located in rural setting to the west of Oxford. The provider, Dr Victoria Heath, carries out all the ultrasound screening herself and the services are offered to privately funded patients only.

The premises have been designed specifically for this purpose, and the facilities are all on the ground floor. There is a large waiting room and reception desk, the ultrasound room and a disabled toilet. In addition, there is a staff kitchen and store room, with an area for records storage on an upper floor. There is extensive adjacent parking.

Beard Mill Clinic is registered to provide the regulated activity diagnostic and screening procedures.

We inspected this service using our comprehensive inspection methodology. We carried out the short-notice (48 hours) announced inspection on 30 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.

We have not rated this service before and we rated this service as Good overall.

We found good practice in relation to:

• The provider, Dr Victoria Health, had the skills, training and experience to keep people safe from avoidable harm and provided the right care and treatment. She ensured she was competent for her role and had the right skills and abilities to run the clinic service to benefit patients, working well with specialist services and GPs. She checked staff in the contracted reception service had the right skills and training to provide the right care.

• The service controlled infection risk well. The premises were kept clean and the provider used control measures to prevent the spread of infection.

• The clinic had suitable premises and equipment and the provider looked after them well.

• The provider reviewed and updated risk assessments for each patient, using a tailored patient questionnaire and kept detailed records of patients’ care and treatment. The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards. The provider sought patients’ consent for a scan and for holding personal information.

• The provider had systems to manage patient safety incidents.

• The service provided care based on national guidance and evidence of its effectiveness and monitored the effectiveness of care. The provider used these results to improve practices.

• The service offered flexible appointment times so people could access the service when they needed it.

• The provider cared for patients with compassion and offered emotional support to reassure them and minimise any distress. The service took account of patients’ individual needs and put them at the heart of services. Patient feedback was consistently positive about the provider’s reassurance, kindness and support, and the provider had good links to counselling services.

• The provider involved patients and those close to them in decisions about their care and treatment.

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

• The service treated concerns and complaints seriously, investigated them and learned lessons from the results.

• The service had a vision for what it wanted to achieve and reviewed this based on patient feedback and local engagements with services. The provider promoted a positive culture combining high quality services and a relaxing, welcoming environment.

• The provider had a systematic approach to improving the quality of service

• The service had identified some risks and put in plans to eliminate or reduce them.

• The service was committed to improving services by learning from when things went well or wrong, promoting training, research and innovation.

We found outstanding practice

• The provider had a range of approaches to assess their quality of practice. These included reviewing results against benchmarked data, evaluating patient feedback against fetal measurements and obtaining peer reviews on their own performance. This demonstrated a strong commitment to providing high quality patient care.

However, we also found the following issues that the service provider needs to improve:

• The service had not identified and reviewed new hazards to mitigate their risks.

• The provider had not risk assessed all the non-clinical cleaning materials used on the premises, in line with the Control of Substances Hazardous to health (COSHH) regulations.

• The provider had not referenced details on the types of incidents that must be reported to other agencies, such as the CQC, in the incident reporting policy.

Nigel Acheson

Deputy Chief Inspector of Hospitals London and South

We met with three service users; one relative and the manager of the clinic. We also made observations on the facilities and environment.

All the service users and the relative were unanimous in agreeing that they felt that they were very well cared for. One service user described the clinic as a "first class facility". Another told us that she received "fabulous treatment". The relative said that he had been particularly impressed with the time the manager took to explain things and to reassure him.

We saw that the clinic was well maintained with a strong emphasis on safety given that small children were likely to be attending the clinic with their parents. There was adequate parking and good access into the clinic.