This changing pad is perfect for our needs and has served us well for over a year and a half now. It's very well cushioned, and the strap that attaches to the changing table is great for keeping it in place. We didn't use it at first, but at one point our daughter figured out how to push herself off the wall with her feet and slide the whole changing pad away from the wall, so we had to quickly attach the strap to the dresser that we use as a changing table. She lost interest after she was no longer able to push herself around. But that strap that's drilled into the dresser was literally a lifesaver! I also love the 4 walls. Our baby also liked pushing up with her feet and scooting around the pad, so keeping her contained on all four sides was also crucial.
As far as cleanability goes... Well, I really wish they hadn't punctured the entire surface of the pad with all these little holes!!! They're not even stitch holes - there are no stitches forming the quilt-like pattern - no, it's just holes into the waterproof surface! Dumbest thing ever - why would you create a waterproof surface, and then drill a million holes into it?!?!? So, practically, it is not waterproof. You can see the foam underneath through the holes. Once liquid gets in there, there's no way to clean it out. You can wash the surface, but the foam in the holes remains stained. Luckily, our baby has never pooped on the pad, and only peed on it maybe twice in 20 months, and even then it was mostly contained in the open diaper under her butt or on the bath towel, so it hasn't been a problem. That's why we've been using it without a liner (the surface is very soft and pleasant, not plasticky). If your baby isn't prone to accidents in the short amount of time the diaper is open, then this pad is great all around and can be used as is (ours lasted over a year and a half of daily use before it started developing tears). But if your baby does have frequent accidents, then you'd need to use a separate waterproof liner on top of the pad, or just get another changing pad altogether.
UPDATE: I feel like I need to add this, even though I don't want to sound like I'm lecturing people. Some changing pads have a strap to buckle the baby down, some don't. Some people put the pad on a high surface, some put it on the bed or floor. But with the popularity of "changing tables" and other such high furniture, it's likely that a lot of people are placing these things high up, and, let's face it, probably not buckling their babies in. I myself didn't do it every time. I thought it wasn't necessary if I was right there. Until one day I stepped 3 feet to the side for two seconds, and my 7-month-old baby flipped himself out of the changing pad and fell head first towards the hard tile floor... I lunged and caught him, just as his head grazed the ground, and in doing so I smashed my own face into the corner of the wall. I'd much rather have a broken face than a broken/dead baby, but if I'd used the buckle that the pad came with, I wouldn't have had to have either. I will never think the buckle unnecessary or silly again. People, buckle your babies, even if you're right there! All it takes is a second, and it could be a second too long!