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Inspection Summary


Overall summary & rating

Good

Updated 11 February 2019

InHealth Hornchurch is operated by InHealth. The service provides magnetic resonance imaging (MRI) diagnostic facilities for adults and young people over the age of 16 years. At the time of inspection all patients attending the centre were NHS funded patients.

We inspected MRI diagnostic facilities.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 28 November 2018.

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 (MCA).

The main service provided by this centre was MRI.

Services we rate

This was the first inspection of this service. We rated it as Good overall.

We found good practice in relation to diagnostic imaging:

  • There were effective systems to keep people protected from avoidable harm.

  • There were sufficient numbers of staff with the necessary skills, experience and qualifications to meet patients’ needs.

  • There was a programme of mandatory training which all staff completed, and systems for checking staff competencies.

  • Equipment was maintained and serviced appropriately and the environment was visibly clean.

  • Staff were trained and understood what to do if a safeguarding issue was identified.

  • Records were up to date and complete and kept protected from unauthorised access.

  • Incidents were reported, investigated and learning was implemented.

  • The service used evidence based processes and best practice, this followed recognised protocols. The referral to scan times and scan to reporting times were appropriate and well within expected ranges.

  • Staff were competent in their field and kept up to date with their professional practice.

  • Staff demonstrated a kind and caring approach to their patients and supported their emotional needs.

  • Appointments were available during the evening, at weekends and at short notice if required.

  • Complaints from patients were taken seriously and acted upon.

  • The service had supportive and competent managers. Staff understood and were invested in the vision and values of the organisation. The culture was positive and staff demonstrated pride in the work and the service provided.

  • Risks were identified, assessed and mitigated. Performance was monitored and performance information was used to make improvements.

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

  • Cleaning materials were not stored in accordance with the Control of Substances Hazardous to Health Regulations 2002 (COSHH). In mitigation the COSHH store cupboard was locked by the registered manager at the time of inspection and staff were informed that the cupboard must be locked when not in use.

  • A first aid box had out of date dressings. The first aid box did not have a record sheet with the date, name, signature and role of the person checking the contents.

  • Patients were triaged via the central InHealth patient referral centre (PRC), However, staff did not know if there was a localised protocol for referrals from non-medical referrers.

  • Staff had not undertaken training on the Mental Capacity Act 2005 and associated guidance. The provider had purchased a training package and work was in progress to roll this training out to staff.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. These can be found at the end of the report.

Nigel Acheson

Deputy Chief inspector of Hospitals (London and the South)

Inspection areas

Safe

Good

Updated 11 February 2019

We rated safe as Good because:

  • There was an open incident reporting culture within the centre and an embedded process for staff to learn from incidents.

  • All staff demonstrated an understanding of the duty of candour and the principles behind this.

  • Staff were knowledgeable about safeguarding processes and what constituted abuse.

  • There were sufficient numbers of staff with the necessary skills, experience and qualifications to meet patients’ needs. They were supported by a programme of mandatory training in key safety areas.

  • Equipment was serviced and there were processes to ensure all items were well maintained. The environment was visibly clean.

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

  • Cleaning materials were in an unlocked store room. This was not in accordance with the In mitigation the room was locked at the time of inspection and staff informed that these must be locked when not in use.

  • A first aid box had out of date dressings. The first aid box did not have a record sheet with the date, name, signature and role of the person checking the contents.

Effective

Not sufficient evidence to rate

Updated 11 February 2019

We do not currently rate effective for diagnostic imaging.

  • Policies, procedures and guidelines were up to date and based on National Institute for Health and Care Excellence (NICE) guidelines, relevant regulations and legislation.

  • Staff worked collaboratively as part of a multi-professional team to meet patients’ needs.

  • There were systems to show whether staff were competent to undertake their jobs and to develop their skills or to manage under-performance.

  • Information provided by the centre demonstrated 100% of staff had been appraised.

  • Staff had regular development meetings with their centre manager, and were encouraged to develop their roles further.

  • There was effective multidisciplinary team working throughout the centre and with other providers.

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

  • Staff had not undertaken training on the Mental Capacity Act 2005 and associated guidance. The service had purchased a training package and work was in progress to roll this training out to staff.

Caring

Good

Updated 11 February 2019

We rated caring as Good because:

  • Patients were treated with kindness, dignity and respect. This was reflected in feedback we received from patients.

  • Patients received information in a way which they understood and felt involved in their care. Patients were always given the opportunity to ask staff questions, and patients felt comfortable doing so.

  • Staff provided patients and those close to them with emotional support; staff were supportive of anxious or distressed patients

Responsive

Good

Updated 11 February 2019

We rated responsive as Good because:

  • Services were planned and delivered in a way that met the needs of the local population.

  • Patients’ individual needs were met, including patients living with dementia and learning disability.

  • Complaints were investigated and learning was identified and shared to improve service quality.

  • Appointments could be provided on the same day. Alternative appointment time were offered to patients who worked during the week.

  • Patients could access services easily; appointments were flexible and waiting times short. Appointments and procedures occurred on time.

Well-led

Good

Updated 11 February 2019

We rated well-led as Good because:

  • The provider had a clear vision and values which were realistic and reflected through team and individual staff member objectives.

  • There was a clear governance structure, which all members of staff understood. There was evidence of information escalated from local level governance meetings and information cascaded from provider level governance meetings.

  • Staff were positive about their local leaders and felt they were well supported.

  • The centre had its own risk register and managers understood the risks and actions to mitigate them.

  • There was a culture of openness and honesty supported by a freedom to speak up guardian.

Checks on specific services

Diagnostic imaging

Good

Updated 11 February 2019

Diagnostics was the only activity the service provided. We rated this service as good because it was safe, caring, responsive and well-led.

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