Lycahealth Orpington Limited

Updated 11 April 2022

Lycahealth Orpington Limited is operated by LycaHealth Orpington Limited and offers outpatients and diagnostic imaging services.

Outpatients services are delivered from a purpose-built facility with consulting rooms, an audiology suite, physiotherapy gym, and diagnostic imaging centre on site. Clinical specialties include breast ultrasound, heart and chest, gynaecology, orthopaedics, oncology, sports medicine, ear, nose, and throat, and spine and brain.

The provider offers GP services and health screening for life stages, stress assessments, and corporate medicals. We did not include these in our inspection. A number of clinical services delivered by other providers take place on site. These do not form part of our inspection or ratings other than consideration of local safety procedures.

The centre provides the following diagnostic imaging services: computed tomography (CT) scans, X-ray, mammography, magnetic resonance imaging (MRI) scans and ultrasound. The site provides a service for patients aged 16 and above and operates six days a week, Monday to Saturday. About 11.5% of patients for diagnostic imaging came from NHS referrals through an arrangement with local NHS trusts.

The number of outpatient appointments each day varies based on consultant availability and the number of clinics in operation. The service works with other independent providers and NHS services to deliver care that meets needs across the region.

The clinic is spacious and comfortable with good facilities for patients and those accompanying them.

The provider registered this location in 2016 and we have not previously carried out an inspection.

The service has a registered manager, who had been in post since May 2019, and is registered to provide the following registered activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury

Where our findings on outpatients – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the outpatients service.

We rated this service as good because it was safe, caring, responsive and well led. We inspected but did not rate effective.

Updated 11 April 2022

We had not previously inspected this service. We rated it good because:

• 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 assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, 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.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. 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:

• Staff did not always ensure all paper patient records were stored securely.
• Fire safety procedures and audits had not identified existing safety risks.
• Completion rates for mandatory training were relatively low.
• Not all staff had an up to date appraisal.
• The key to the MRI scanning room was not in a locked cupboard which meant non-authorised staff could potentially gain access to the scanning room.
• The service did not have cleaning records for staff to complete for cleaning of the MRI and CT scanning rooms.
• There was no system in place to ensure the emergency resuscitation bag was secured from tampering.
• There was no system in place to monitor the wellbeing of patients who failed to attend a planned outpatient appointment.

Following our inspection, the provider told us they took action to address all items identified for improvement.

Updated 11 April 2022

This was the first inspection of the service. We rated it as good because:

• Staff had training in key skills, understood how to protect patients from abuse, and managed safety well.
• Staff provided good care and treatment. Staff worked well together for the benefit of patients and supported them to make decisions about their care.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. 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. Staff planned services around patients’ needs and operated additional clinics to make sure patients could access diagnostic imaging.
• The service was well led and governance processes ensured appointments ran smoothly.

However:

• The key to the MRI scanning room was not in a locked cupboard which meant non-authorised staff could potentially gain access to the scanning room.
• The service did not have cleaning records for staff to complete for cleaning of the MRI and CT scanning rooms.
• There was no system in place to ensure the emergency resuscitation bag was secured from tampering.
• The service had not held a radiation protection committee meeting since the end of 2017.

Where arrangements were the same for diagnostic imaging and outpatients, we have reported our findings in the outpatients section.

We rated this service as good because it was safe, caring, responsive and well-led. We do not rate effective for diagnostic imaging.

Updated 11 April 2022

We rated the service as good because:

• There were enough qualified, trained staff to deliver safe care.
• The service managed medicines safely and followed good practice with respect to safeguarding.
• Patients had access to a wide range of specialists. Managers ensured that these staff received training, supervision and appraisal.
• Staff worked well together as a multidisciplinary team and liaised well with local and regional providers to coordinate care.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood their individual needs. They involved patients and families and carers in care decisions.
• The service was well led, and governance processes ensured clinics ran smoothly.

However:

• Patient records were not always securely stored.
• Fire safety procedures and audits had not identified existing safety risks.
• Completion rates for mandatory training were relatively low.
• Not all staff had an up to date appraisal.
• There was no follow up for patients who did not attend their appointments.

We rated this service as good because it was safe, caring, responsive, and well led.