Temporary closure of clinic over concerns
OUT-OF-DATE blood testing kits, dirty equipment and a manager taking home and disposing of clinical waste in her own household bin.
These were some of the issues discovered by inspectors as they visited a clinic offering services to pregnant women.
Care Quality Commission officials headed to Miracle in Progress after receiving “concerning information” about the Shepshed-based provider.
The CQC team, which was on site in April this year, issued an urgent suspension of registration and temporarily closed down the clinic.
The suspension was lifted and the clinic reopened after a follow up visit by inspectors 13 days later.
In a recently-published report about the visit, inspectors stated: “The notice was given because we believed that a person will or may be exposed to the risk of harm if we do not take this action.”
The clinic provides a range of scans including gender scans, early pregnancy scans, gynaecology scans and 4d scans.
It also offers tests, including screening tests for Down Syndrome and conditions, as well as blood and fertility tests.
Prices and packages for scans and tests range from £49 to £450.
Concerns highlighted by inspectors included:
Staff did not always keep themselves, equipment and the premises clean. They did not use control measures to prevent the spread of infection;
There was no mandatory training for two out of three staff. The registered manager said they had attended mandatory training, but could not provide evidence;
The processes for the disposal of clinical waste were described as inadequate;
Out-of-date consumables, including blood testing kits and blood bottles, were found in scan rooms. Inspectors were not assured that processes were in place to ensure that these would not be used;
There were no processes in place to ensure equipment was in good working order and clean;
Sensitive patient information was found throughout the clinic.
Joanna Proud is listed as the service’s registered manager in the CQC’s write-up.
During inspectors’ first visit, Ms Proud told the officials that the clinic did not have clinical waste bags and that all clinical waste was removed from the site by herself, taken home and disposed of in her own household bin.
When asked what would happen to clinical waste that had been used for internal examinations, the manager said that she would take the waste home and burn it.
When pushed further, the manager admitted there was no clinical waste contract in place for the service.
When inspectors returned to reassess the service, the manager was able to present evidence of a clinical waste disposal contract.
Scan rooms were described as cluttered and potential fire risks.
One inspector observed two scans and said that the equipment was not cleaned between patients.
It was added that there was no evidence that machines were clean and ready for use on a regular basis.
Inspectors said that in both scan rooms the TV monitors were “visibly dirty and full of dust”.
The report states: “We had no assurance the equipment was in good working order and would not place women at risk of harm.”
The cleaning policy said equipment should be cleaned with sanitising powder after every use and that aprons should be used whilst cleaning. Inspectors found neither product available on site during the inspection.
After one scan, inspectors entered a room and asked a staff member how they had decontaminated their hands.
They replied that they had used the sink in the scan room.
The report reads: “We noticed the sink was dry, the hand soap dispenser was empty, and no hand drying towels were available in the dispenser, we were therefore not assured appropriate hand hygiene had taken place.”
Hand washing facilities were not available in all rooms during the first inspection.
When inspectors returned, they found that they had been fitted in all scan rooms.
“Visibly dirty and encrusted” hand gel dispensers were at the entrance to scanning rooms.
Bottles within them had expiry dates of 2017.
When questioned about it, the manager told inspectors that the bottles were refilled rather than replaced when they were empty.
However, inspectors could not find any replacement gel at the time of the inspection.
In-date hand gels were in place when inspectors returned.
Six out of seven blood testing kits in one scan room were out of date.
In another room, inspectors found 13 blood bottles which had expired.
The manager told the CQC team that staff would check dates before using any consumables.
But, the report stated: “Staff had no oversight of expiring consumables, we were not assured this would be the case as there was no process to support this.”
When inspectors returned all out-of-date equipment had been removed and equipment areas were “visibly tidy”.
Other concerns raised by inspectors in the report included:
There was no escalation policy for women who appeared unwell or displaying medical symptoms;
The safeguarding policy was not up-to-date;
Staff were not knowledgeable about child sexual exploitation or female genital mutilation;
Staff were not chaperone trained;
Scan rooms were carpeted or had rugs and some furniture was not wipeable, presenting a risk of contamination when it came to blood tests.
When inspectors revisited the clinic carpets had been removed or steam cleaned and furniture had been replaced, while staff had been fully trained.
Inspectors praised the culture of the service and wrote: “There was a culture which wanted to deliver the best possible care to women.
“All staff in the provider demonstrated a caring attitude to want to deliver the best care they could.
“Throughout our inspection the clinic manager responded positively to feedback and asked about improvements that could be made.”
A public register states that Joanna Proud was suspended for 18 months by the Nursing and Midwifery Council (NMC) in March, pending an investigation.
A spokesman for the NMC confirmed that the interim suspension order prevents Ms Proud from practising as a nurse or a midwife for the period.
The spokesman could not give any indication as to why the order was issued.
Responding to Leicestershire-Live’s request for a comment in relation to the CQC inspection, Ms Proud, said that the clinic had received a “long overdue, on the spot inspection” from the CQC.
“The CQC conducted its inspection to a new set of standards they have devised for private clinics of our nature,” she added.
“As a result of this inspection the CQC highlighted some areas of improvement required and as a team we have worked tirelessly to eradicate any areas of concern.
“This was duly acknowledged by the CQC at their follow-up visit, where it commented that we had worked hard to overcome the concerns raised upon the initial inspection.”
Ms Proud added that Miracle in Progress had been subject to some major changes in recent years which had created “a period of unrest”.
“The business has also grown massively - a dedicated team is now in place including a business manager to ensure we operate to the highest standards,” she added.
“The team have taken on board recent observations raised by CQC and have ensured all areas of concern are rectified and as a result the business is a more professionally run, efficient service.
“We will continue to work alongside the CQC to ensure we continue to offer the highest level of service to all.
“The team are entirely committed to ensuring that all clients receive a safe, informative and enjoyable experience upon visiting the clinic.
“The public can be assured we have the highest qualified sonographers who are passionate about delivering the best level of service to all clients.”
Asked about the NMC suspension, Ms Proud said she would not be providing further comment.