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Lyca Health Canary Wharf Limited

Inspection Summary


Overall summary & rating

Updated 16 April 2018

We carried out an announced comprehensive inspection on 7 November 2017 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Lyca Health Canary Wharf Limited provides diagnostic and imaging services, including MRI, ultrasound and X-Ray, from a purpose built location in Canary Wharf, London. The location includes 20 clinical rooms, which are used by consultants and other clinicians under practising privileges. The granting of practising privileges is an established process within independent healthcare whereby a medical practitioner is granted permission to work in an independent hospital or clinic, in independent private practice, or within the provision of community services. The organisation is based at Ground Floor, Devere Building, 1 Westferry Circus, London, E14 4HA.

The service which commenced operations in 2016, is overseen by a Board of Directors which includes clinical and non-clinical members, including the Chief Executive Officer who is a consultant radiologist.

The Chief Operations Manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

On the day of inspection we collected 11 CQC comment cards filled in by patients. This information gave us a positive view of the service.

During the inspection we spoke with the chief executive officer, the Chief Operations Manager, one nurse, three clinical staff and members of the administration team. We looked at service policies and procedures and other records about how the service is managed.

Our key findings were:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • There were clear processes for reporting incidents about the Ionising Radiation (Medical Exposure) Regulations 2000 (IR (ME) R).
  • Risks to staff and people who used the service were assessed and well managed.
  • Staff assessed peoples’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • People who used the service said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and people who used the service, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The service had a suite of safety policies including adult and child safeguarding policies which were regularly reviewed and communicated to staff.

There were areas where the provider could make improvements and should:

  • Review infection prevention and control arrangements by following through with plans to review handwashing arrangements in the CT room.
  • Review how information about the cost of procedures is presented on the service website.
  • Ensure that Radiation Protection Audits and checks on lead aprons are undertaken regularly.
  • Put steps in place to ensure Local Rules are reviewed regularly and changes made in line with regulations. Local Rules summarise the key working instructions intended to restrict exposure in radiation areas and include a description of the area covered by the Rules, its radiological designation and the radiological hazards which may be present in the area.

Inspection areas

Safe

Updated 16 April 2018

We found that this service was providing safe care in accordance with the relevant regulations.

We found one areas where improvements should be made relating to the safe provision of treatment. This was because handwashing arrangements in one clinical room were not in line with best practice.

  • The service had a suite of safety policies including adult and child safeguarding policies which were regularly reviewed and communicated to staff.
  • There were clear processes for reporting incidents about the Ionising Radiation (Medical Exposure) Regulations 2000 (IR (ME) R).
  • Appropriate environmental measures, including signs, were in place to identify areas where radiological exposures were taking place in line with the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R).
  • All staff received up-to-date safeguarding and safety training appropriate to their role.
  • The service ensured that facilities and equipment were safe and that equipment was maintained according to manufacturers’ instructions.
  • On the day of the inspection, we noted that Local Rules were in place but were out of date. After the inspection, we were provided with evidence which showed that Local Rules had been reviewed and changes had been made to ensure that these were in line with regulations.
  • Personal protective equipment (PPE), such as gloves, aprons as well as specialist x-ray protection PPE, including thyroid shields and lead aprons, were readily available for staff to use in all clinical areas.
  • There were comprehensive risk assessments in relation to safety issues.

Effective

Updated 16 April 2018

We found that this service was providing effective care in accordance with the relevant regulations.

  • The service’s policies and procedures referred to professional guidance produced by the National Institute for Health and Care Excellence (NICE), and the Royal College of Radiology.
  • The service had a clinical audit programme in place which would ensure compliance with NICE guidelines.
  • Clinical policies and procedures were available on the hospital’s intranet and staff were aware of how to access them.
  • The provider reviewed the effectiveness and appropriateness of the care provided. All staff were actively engaged in monitoring and improving quality and outcomes.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff had access to policies and guidance related to their roles
  • The service shared relevant information with the person using the services’ permission with other services.

Caring

Updated 16 April 2018

We found that this service was providing caring services in accordance with the relevant regulations.

  • Staff were sensitive to patients’ personal, cultural, social and religious needs.
  • People had access to chaperones during consultations and treatments and this was clearly advertised through signs in waiting areas and consulting rooms.
  • Staff told us that people using the service were given time to ask questions about their procedures and were helped to understand what would happen.
  • Staff showed a clear understanding of the importance of providing emotional support to people undergoing procedures.
  • Feedback received from people who used the service through the completed CQC patient comment cards told us that clinical staff took the time to involve them in their care

Responsive

Updated 16 April 2018

We found that this service was providing responsive care in accordance with the relevant regulations.

We found one area where improvements should be made relating to the responsive provision of treatment. This was because information about the cost of procedures was not clearly displayed on the service website.

  • The service was located entirely on the ground floor of modern premises which had been designed specifically for the purpose of carrying out the services provided.
  • The service had ensured that a wheelchair was available to assist people who found it difficult to move around the premises during their visit.
  • Changing areas were spacious and allowed people to change safely and comfortably.
  • There was a protocol in place to contact people with appointments in the event that equipment was not functioning.

Well-led

Updated 16 April 2018

We found that this service was providing well-led care in accordance with the relevant regulations.

  • Leaders had the experience, capability and integrity to deliver the service’s strategy and address risks to it.
  • Leaders were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.
  • There was a clear vision and set of values. The service had a realistic strategy and supporting business plans to achieve priorities.
  • The provider was aware of and had systems in place to ensure compliance with the requirements of the duty of candour.
  • Staff told us there was an open culture within the service and they had the opportunity to raise any issues at team meetings and felt confident and supported in doing so.
  • Staff told us they were proud to be associated with a charitable foundation established by the provider, whose aim was to provide training opportunities in marginalised communities.
  • The service was forward thinking and outward facing and helped improve the services it delivered by sharing innovation and learning.
  • There was evidence of systems and processes for learning, continuous improvement and innovation.