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Inspection carried out on 13 May 2019

During a routine inspection

Take A Peek Limited is operated by Take A Peek Limited. The service is located in St. Helens, Merseyside and provides a range of diagnostic ultrasound scan services for private fee paying pregnant women of all ages.

The main service provided by the service is diagnostic imaging. We inspected this service using our comprehensive inspection methodology on 13 May 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

This is the first time we have rated this service. We rated it as Good overall.

We found the following areas of good practice:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well.
  • The service controlled infection risk well. Staff kept good care records. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent.
  • Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
  • People could access the service when they needed it and did not have to wait too long for treatment. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff.
  • Leaders had the integrity, skills and abilities to run the service. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.
  • Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

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

  • The service did not have effective governance arrangements in place to ensure high standards of care were maintained at all times.
  • Policies and procedures did not always include version controls or review dates. Sufficient staff recruitment checks had not been carried out for all staff.
  • Risks had not been effectively managed in areas such as staff recruitment checks, monitoring of staff training requirements, management of policies and procedures and lack of professional indemnity insurance arrangements. Staff did not keep documented records of risk assessments for each patient.
  • There was no documented audit or monitoring in place to cover staff recruitment files, mandatory training compliance and overall governance processes and policies.
  • Staff had completed mandatory training in key skills; however the service did not have an effective system in place to identify training needs and monitor compliance for all staff.
  • The service did not have any spill kits for cleaning up spills from bodily fluids.
  • The service did not have processes in place for staff appraisal or supervision meetings in order to provide support and monitor the effectiveness of the service
  • Not all staff had completed equality and diversity training and there was no information available for patients that were unable to speak English.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected diagnostic imaging services. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North Region)

Inspection carried out on 28 November 2013

During a routine inspection

Information was available to people using the service on the company's website and in leaflets. This provided people with information to help them make decisions about the type of scan they required and what to expect during the consultation.

The service had an onward referral policy which gave detailed guidance regarding referring people to other services if any concerns were identified. One person we spoke with told us,”The care I received was outstanding. The service has excellent links with NHS services.”

Records showed annual maintenance checks had been completed on the ultra sound equipment used. This meant that the equipment used by the service had been appropriately checked and was safe to use. Staff training records showed the sonographers had received training in how to use the new equipment being installed.

All of the sonographers had appropriate professional qualifications. Two were radiographers and one was a midwife. Records showed they had up to date registration with their professional bodies.

One of the sonographers took the lead on quality and responded to any concerns raised. There had been no complaints since our last inspection.

Inspection carried out on 28 February 2013

During a routine inspection

People were supported in making the decision about having an ultrasound scan through information about the procedures on the web site and in the service’s information leaflet. We saw in people’s care records that consent to the ultrasound procedure had been sought on the day of the appointment..

The four people we spoke with told us they were very satisfied with the care they had received. Comments included, “We really have confidence in the staff, they are very professional and caring” and “They [the staff] don’t rush you and are very flexible.”

The sonographer spoke directly to people prior to the appointment if they had any concerns or required more information about the procedure. The service had procedures in place to manage emergencies or when they identified concerns on the scans.

The service had policies and procedures in place relating to ‘safeguarding vulnerable adults’ and ‘child protection’. Sonographers attended regular safeguarding training and records showed that these were up to date.

We found that the service was delivered by three specialist healthcare professionals in accordance with the recommendations of the Health Protection Agency.

The service had systems in place to record, and securely retain, information regarding the care delivered to people and the running of the service. The service had procedures in place for the safe destruction of confidential information and staff we spoke with were knowledgeable about them.

Inspection carried out on 5 September 2011

During a routine inspection

We did not speak to any people using the service during our visit.

We read testimonials from people who have used the service that are recorded on the website for Take A Peek Limited. These showed that people have had a positive experience.

The service plans to introduce questionnaires for people who have had a scan so they can gather feedback on what is working well and where any improvements need to be made.

The records at the service showed there had been no complaints. No complaints or concerns have been brought to the attention of the Care Quality Commission.