Parkway

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question as good. At this inspection the rating has remained good.

We found 2 breaches of the regulations in relation to safe care and treatment and fit and proper persons employed. Routine servicing of ultrasound equipment was not always conducted within a suitable timeframe, and there were no clear contingency plans if equipment stopped working. Staff files did not always contain evidence of mandatory training for freelance staff, and appropriate pre-employment checks of qualifications and professional registration were not always conducted.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

This section was assessed using findings that are applicable to the whole Parkway site, which are included in the appropriate section of the surgery report.

We observed sonographers check service users’ understanding of their referral before scanning, advising them when the referrer would receive their report and what would happen next. Ultrasound scan reports were routinely completed immediately after the scan had taken place and audited regularly to ensure the related images had been transferred to the appropriate system.

The service recently identified that due to administrative oversights, MRI scan reports had never been received or acted upon for 56 service users, leading to a significant delay in the review of clinical findings for these individuals. The service had identified the causes and implemented service improvements in response and followed up with each person concerned. However, the incident report did not address the potential consequences or level of harm for each of the people involved.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

Staff in the service were assigned training in safeguarding to an appropriate level and when asked, they could identify their own responsibilities relating to this, as well as name the safeguarding lead.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

We observed that staff communicated with service users so that they understood their care and treatment, which included finding ways to speak to people who have different needs, such as by using telephone interpretation services.

Sonographers conducted clinics with an assistant who could act as an appropriate chaperone when needed, and staff understood the responsibilities of this role.

A total of 7 portable ultrasound machines were available to use, which were sometimes all in operation at one time. We noted that 3 of the machines had continued to be in use despite not having had their annual service checks done within the last year, with 2 of the machines being 6 months overdue. This meant that the service could not be assured that all of their equipment was safe to use on people.

There was no rolling programme for the replacement of ultrasound machines and no documented plan of what remedial action the service would take if one or more machines broke down unexpectedly. A manager advised us that they would ring the manufacturer if an equipment failure occurred, who may provide a replacement device.

Portable sonography equipment was taken between clinic locations by healthcare assistants and kept in their personal possession when not in use. Basic visual checks of the equipment were undertaken daily, although monthly quality assurance checks were not undertaken or recorded, which is not in keeping with the British Medical Ultrasound Society (BMUS) and Society of Radiographers (SoR) best practice guidelines.

At the time of the inspection the service employed 7 MRI radiographers and 12 sonographers working in a mixture of freelance and substantive posts, who were able to meet the capacity of the service. Staff said they felt supported by leaders to manage their workload and capacity. The operations manager for Parkway was overseeing the service in the absence of a clinical lead.

Compliance rates for mandatory training were poor in some areas, including ‘Essentials of patient safety for all staff’ and ‘Consent’ e-learning modules. Freelance staff were required to provide evidence of mandatory training where it had been completed as part of their work with another provider, but this could not always be evidenced in each staff file we reviewed.

We noted that none of the sonographers had completed an appraisal or attended a service group meeting since February 2024. This meant there was no opportunity for them to discuss their development or highlight any training needs. There was also no structured peer review of competence or supervision process, other than an image quality audit that was conducted remotely.

We identified that one member of staff lived overseas, who remotely undertook the image quality audit. This individual was not recorded in any current staff list, and the content of his staff file had not been reviewed in over 10 years. When we queried this, the provider was able to locate the file and added their name to the staff list. We noted that the service did not have a policy or procedure that addressed how criminal record checks should be reviewed for a member of staff living overseas.

We identified that one sonographer who we did not observe during the inspection was working for the service despite not having registration with a regulatory or voluntary body. Their file also did not contain a copy of a qualification certificate required for their role. This was not in keeping with the provider’s safer recruitment policy.

Staff understood and adhered to infection control principles and had access to suitable handwashing facilities. We saw that appropriate personal protective equipment (PPE) was available and used correctly by staff, and that the clinical environment met a good standard of cleanliness. Sonography equipment was disinfected after use, and clinical waste was disposed of in line with current guidance.

Infection control processes were audited quarterly and had demonstrated good compliance across all key areas. These had been previously discussed at user group meetings, although these hadn’t taken place since February 2024.

Staff demonstrated an understanding of the need to decontaminate transvaginal (TV) ultrasound transducers, but the serial number of each TV probe was not always recorded per scan, and so the usage of each probe could not be traced if a service user subsequently reported they had an infectious disease. This was not in keeping with BMUS best practice guidelines for probe decontamination.

We did not look at this quality statement during our inspection, and so the associated score is based on the previous rating for safe.