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Ultrasound Scanning Services Ltd Good

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 5 April 2019

Ultrasound Scanning Services Ltd is operated by Ultrasound Scanning Services Ltd. The Service offers diagnostic tests in the form of ultrasounds for adults. The service has one treatment room and a reception area.

The service provides scans for; early pregnancy 3D or 4D, gender reveal, upper abdomen, pelvic, kidneys and bladder, testes, thyroid, carotid arteries, musculoskeletal such as muscles and tendons, shoulders and conditions including deep vein thrombosis.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 05 February 2019. We went back to do a planned follow up inspection on 15 February 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.

Services we rate

We rated the service as Good overall.

We found areas of practice that was good at this diagnostic service:

  • Staff understood how to protect patients from abuse and recognise different types of abuse.

  • The cleaning wipes used for the transvaginal probe were in line with national recommendations.

  • The service reported 100% compliance in their handwashing audits.

  • Service users with a wheelchair could access the service easily, either via the ramp at the main door or at the side entrance.

  • The service complied with the pause and check guidance from the Society of Radiographers.

  • The service followed guidelines set out by the British Medical Ultrasound Society, Society of Radiographers for professional ultrasound practice and The National Institute for Health and Care Excellence (NICE) guidelines.

  • The service operated seven days a week and provided flexible appointment to meet the needs of their patients.

  • Patients we spoke with said that staff were thorough and took the time to explain findings with them.

  • Staff we spoke with stressed the importance of treating patients as individuals.

  • The service accommodated urgent referrals by ensuring that two urgent appointment slots were available every day.

  • Prices of ultrasound scans were clearly visible to service users.

  • Ultrasound reports were sent to the patient’s GP within two working days for NHS patients.

  • The service was managed by the lead radiographer who was suitably qualified for the role.

  • The service had enough staff with the right qualifications, skills and experience to keep people safe from avoidable harm and to provide the right care and treatment.

However,

  • Staff were not up to date in mandatory and safeguarding training.

  • The service did not hold cleaning logs of the service and we could not see documentation that supported daily cleaning.

  • The service did not have access to an interpretation service, we found that this was rectified on our follow up inspection.

  • The service did not have a documented vision or strategy.

  • The risks in the risk register did not have an entry date or a mitigated date.

  • The manager regularly audited the radiographers work but did not share feedback from these audits with staff.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Professor Edward Baker

Chief Inspector of Hospitals

Inspection areas

Safe

Requires improvement

Updated 5 April 2019

We rated it as Requires improvement because:

  • There was poor compliance in up to date mandatory training, but staff we spoke to at the follow up inspection said that all mandatory training had been booked in, and was due to be completed in the coming month.

  • There was poor compliance with up to date safeguarding training level one and level two, but this had been rectified since the inspection.

  • Not all staff were trained in safeguarding children and therefore we were not assured that staff could recognise a vulnerable child. However, all staff had now been booked in for level one and level two safeguarding training.

  • The provider did not hold cleaning logs or documentation for areas that had been cleaned. Staff we spoke to during the follow up inspection told us that the provider was starting to produce cleaning logs.

However;

  • Staff understood how to protect patients from abuse and recognise different types of abuse.

  • The service was clean and the equipment was well maintained.

  • The cleaning wipes used for the transvaginal probe were in line with national recommendations.

  • The service reported 100% compliance in their hand washing audits.

  • The service complied with the pause and check guidance from the Society of Radiographers.

  • Staff were competent in the escalation process in line with the providers policy for an unwell patient.

  • The service had enough staff with the right qualifications, skills, and experience, to keep patients safe and provide the right care treatment.

  • The provider had a lone working policy in place, and reduced lone working by ensuring administration staff were always present after hours.

  • There were no reported incidents in the reporting period between February 2018 and January 2019.

  • There were no never events in the reported period between February 2018 and January 2019.

Effective

Updated 5 April 2019

CQC does not apply a rating to effective for this type of service. However, we found the following:

  • The service followed guidelines set out by the British Medical Ultrasound Society, Society of Radiographers for professional ultrasound practice and The National Institute for Health and Care Excellence (NICE) guidelines.

  • The manager regularly audited the radiographer’s scans.

  • Clinical professional development was encouraged and the manager was currently undertaking a Master of Science degree in musculoskeletal ultrasound.

  • The service operated seven days a week and provided flexible appointments to meet the needs of their patients.

  • The provider provided water to patients, friends and family.

Caring

Good

Updated 5 April 2019

We rated it as Good because:

  • Staff cared for patients with compassion.

  • Patients that we spoke with said that the radiographers were friendly, informative and made them feel at ease.

  • Staff reacted well to patient emotional needs, for example providing tissues to patients who needed it and allowing patients, family members and relatives time alone to digest information.

  • Patients family and relatives that we spoke with said that they would recommend the service to their own friends and family.

  • Patients we spoke with said that staff were thorough and took the time to explain findings with them.

  • Staff we spoke with stressed the importance of treating patients as individuals.

Responsive

Good

Updated 5 April 2019

We rated it as Good because:

  • The service accommodated urgent referrals by ensuring that two urgent appointment slots were available every day.

  • Clinic times were extended to accommodate patients that presented with a bleed in an emergency.

  • Service users could access this service when they needed to and could self-refer.

  • Prices of ultrasound scans were clearly visible to service users.

  • Ultrasound reports were sent to the patient’s GP within two working days for NHS patients.

  • Patients had access to water which was available in the waiting areas.

  • Patients were given the opportunity to make anonymous comments about the service via feedback forms left in reception.

  • We observed that patients were seen promptly, and that there were no waiting lists for private patients.

  • The treatment room had a slave monitor so that patients, family or friends could see the scan images whilst the scan was taking place. A slave monitor in radiography is an additional screen where ultrasound images can be displayed live; for patient, friends and family.

  • Chaperone information was clearly displayed in the waiting area and the treatment room.

  • The service had a couch for patients with a weight limit of 260kg which was suitable for bariatric patients.

  • All appointments were 20 minutes long so that the patient could use the treatment room to adjust to any news and information regarding their scan.

  • The service had a one week waiting time for an ultrasound for NHS patients.

  • There were no waiting times for private patients, who could be seen on the same day of making an appointment.

  • We observed that the service ran on time and that there were minimal waiting times for patients.

  • Within the reporting period of February 2018 to January 2019 there was over 1,800 compliments received by the service.

  • Within the reporting period of February 2018 to January 2019 there was one complaint received by the service, which was resolved in the time as stated on the complaints policy.

  • Information on how to make a complaint was readily accessible to patients.

  • Service users with a wheelchair could access the service easily, either via the ramp at the main door or at the side entrance.

However;

  • There were no leaflets for counselling or dealing with unexpected news.

  • The service did not have a procedure for treating patients with a learning disability or dementia. Staff told us that these patients were not routinely seen at the service.

  • The provider did not have access to an interpreter service for patients whose first language was not English, however the provider had not come across a situation where an interpreter was required. On the follow up inspection we found that the provider now had an interpreter service. 

Well-led

Good

Updated 5 April 2019

We rated it as Good because:

  • The service was managed by the lead radiographer who was suitably qualified for the role.

  • Staff we spoke with described the manager as visible and approachable.

  • Staff we spoke with felt supported, respected and valued.

  • All staff were clear about their roles and understood what they were accountable for and to whom.

  • The service had a second back up ultrasound machine to use in emergencies, if the main machine broke down.

  • We observed that relevant polices and key records were easy to locate and accessible to relevant staff.

  • Patient surveys were in use and questions were sufficiently open ended to allow people to express themselves.

However;

  • The service did not have a documented vision and strategy.

  • The manager regularly audited the radiographers work but did not feedback on these findings.

  • The risks in the risk register did not have an entry date or a mitigated date.

Checks on specific services

Diagnostic imaging

Good

Updated 5 April 2019

              

The service provides ultrasound scans to NHS and private patients, including early pregnancy scans.

We rated this service as good because it was effective, caring, and responsive and well led, although safe requires improvement. We found poor compliance in mandatory training and out of date training in safeguarding.