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The Jack Brignall PET-CT Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 20 May 2019

The Jack Brignall PET-CT Centre is operated by Alliance Medical Limited . The centre facilities include; reception and waiting areas; an administrative area, which includes a research office, and a clinical area. The clinical area includes two scanner rooms, eight uptake rooms, accessible male and female hot toilets (only to be used by patients who had their received radioactive injection) and two laboratories.

The service provides diagnostic imaging using PET-CT. A PET-CT scan is a combination of a PET (positive emissions tomography) scan and a CT (computerised tomography) scan. PET-CT scans are usually performed to help with the diagnosis, assessment and treatment of; cancer, heart and circulatory conditions and neurological (brain) abnormalities.

The centre did not scan children under 18 years due to lack of paediatric support on site

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 1 March 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 rated the service as Good overall.

We found good practice in relation to:

The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. We found good practice in relation to medicines management, record keeping, infection prevention and control and assessing and responding to patient risk.

The department had shown overall good compliance with the Ionising Radiation Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017, however some actions were needed.

Staff were competent in their roles and worked well together to provide good patient care. Care was provided using policies and procedures based on relevant national guidance and evidence-based practice. Effectiveness of care was monitored and benchmarked against other Alliance Medical Limited providers to maintain and improve standards.

Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Patients told us all staff were helpful and understanding, informative, polite, reassuring and explained things well.

The service planned and provided services in a way that met the needs of their patients. Staff ensured patients’ individual needs were met. Patients could access the service when they needed it, appointments were prioritised and reports were made available to referring clinicians in a timely way.

The aim of the service was; to provide high standards of diagnostic imaging to meet the needs of referrers and their patients. The manager monitored service performance and engaged well with patients, customers, commissioners and staff to ensure they met this aim. The service had good systems in place to identify risks and plan to eliminate or reduce them and was committed to learn from when things went wrong or well. The manager of the service had the right skills and abilities to run the service providing high-quality sustainable care.

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

The service did not have a second radiation protection supervisor.

Categorisation of incidents and implementation of recommendations from incident investigations and quality assurance reviews needed to improve.

Where suggestions had come from patient surveys there needed to be some mechanism for informing patients what improvements had been made from their feedback or that their ideas had been considered but the service had not been able to progress them and why.

Patients sometimes had to have their scan rearranged due to problems escorting them from inpatient wards to the department in time for their scan.

There had been a gap of several months when there had been no staff meetings at the centre.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)

Inspection areas

Safe

Good

Updated 20 May 2019

We rated safe as Good because:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it. At March 2019 compliance with mandatory training was 100% for all modules

  • Staff understood how to protect patients from abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The service controlled infection risk well. Staff kept themselves, equipment and the premises clean.

  • The service had suitable premises and equipment and looked after them well.

  • Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary

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

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

  • The service followed safe practice when giving, recording and storing medicines.

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

  • The service needed to train a second radiation protection supervisor to ensure cover when the registered manager was absent

  • Categorisation of incidents and follow up of recommendations from incident investigations needed to improve

Effective

Updated 20 May 2019

We do not currently rate effective for diagnostic imaging services.

We found the following areas of positive practice:

  • The service provided care based on national guidance and evidence of its effectiveness. Radiation protection advisers and supervisors checked to make sure staff followed guidance.

  • Staff assessed and monitored patients regularly during their scan to see if they were uncomfortable or in pain.

  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance, provided support and monitored the effectiveness of the service. They compared local results with those of other services in the Alliance Medical Limited group to learn from them.

  • Staff of different kinds worked together as a team to benefit patients. Staff supported each other to provide good care.

  • Staff understood their roles and responsibilities under the Mental Capacity Act 2005 and in relation to informed consent.

Caring

Good

Updated 20 May 2019

We rated caring as Good because:

  • Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.

  • Patients told us all staff from the receptionist to the scan operator were all very comforting, pleasant and competent. Staff were helpful and understanding, informative, polite, reassuring and explained things well.

  • Staff provided emotional support to patients to minimise their distress.

  • Staff involved patients and those close to them in decisions about their care.

Responsive

Good

Updated 20 May 2019

We rated responsive as Good because:

  • The service planned and provided services in a way that met the needs of local people.

  • The service took account of patients’ individual needs.

  • Staff were understanding of individual needs and made every effort to make sure the service was accessible to all their patients.

  • People could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

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

  • Patients sometimes had to have their scan rearranged due to problems escorting them from inpatient wards to the department in time for their scan.

Well-led

Good

Updated 20 May 2019

We rated well-led as Good because:

  • The manager of the service had the right skills and abilities to run a service providing high-quality sustainable care.

  • The aim of the service was to provide high standards of diagnostic imaging to meet the needs of referrers and their patients.

  • The service systematically checked service quality and safeguarded high standards of care.

  • The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.

  • The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

  • The service promoted a positive culture that supported and valued staff.

  • The service engaged well with patients, staff, the trust and commissioners to plan and manage appropriate services.

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

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

  • There had been a gap of several months when there had been no staff meetings at the centre.

  • The risk relating to staff exposure did not include the new recommendations from a recent incident investigation.

  • There was no process in place to inform patients what improvements had been made because of their feedback or to inform them when suggestions had been made but were not feasible for implementation.

Checks on specific services

Diagnostic imaging

Good

Updated 20 May 2019

We rated this service as good overall with ratings of good for safe, caring, responsive and well-led. CQC does not rate effective for diagnostic imaging services. There were areas of good practice and a small number of things the provider should do to improve. Details are at the end of the report.