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Haywards Heath MRI Unit Good

Inspection Summary


Overall summary & rating

Good

Updated 23 April 2019

Services we rate

We rated this service as  good overall.

We found good practice in relation to diagnostic imaging:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
  • The service had suitable premises and equipment and looked after them well.
  • Staff completed and updated risk assessments for each patient.
  • 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.
  • Staff kept detailed records of patients’ care and treatment.
  • The service followed best practice when prescribing, giving, recording and storing medicines.
  • The service managed patient safety incidents well.
  • The service provided care and treatment based on national guidance and evidence of its effectiveness.
  • Staff gave patients enough food and drink to meet their needs and improve their health.
  • Staff assessed and monitored patients regularly to see if they were in pain.
  • Managers monitored the effectiveness of care and treatment and used the findings to improve them.
  • The service made sure staff were competent for their roles.
  • Staff of different kinds worked together as a team to benefit patients.
  • Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Patients were treated with dignity and respect. The interactions we observed showed staff being professional and compassionate. We heard staff speak to patients in a friendly yet professional manner.
  • Referrals were responded to rapidly. Patients could be offered immediate appointments in case of an emergency.
  • Timely reporting was monitored and facilitated with IT systems allowing results to pass quickly to referrers. Urgent or unexpected findings triggered an immediate process, ensuring results were seen promptly by consultants.
  • Company values had been reviewed and refreshed with staff involvement. Corporate functions supported clinical activity at site level with policies, procedures, resource and effective communication cascaded to ensure that provision met objectives for patient care.
  • We found an open and candid approach to incident and complaint management. Staff we talked with understood their role to ensure candour was routinely applied.
  • Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

We found areas of practice that require improvement in diagnostic imaging:

  • Not all staff working in the clinical area were bare below the elbow.
  • Some policies were outdated and in need of review.
  • There was no local risk oversight to make sure that there was adequate responsibility, accountability and effective management of current risks at a local level, except for the fire and MRI risk assessments.
  • The service was in the process of embedding a formalised staff appraisal programme but this fell below the expected standard of 100% completion.
Inspection areas

Safe

Good

Updated 23 April 2019

We rated safe as Good because:

  • The service provided mandatory training in key skills to all staff and actions were in place to ensure staff compliance.
  • Staff were trained and understood what to do if a safeguarding concern was identified.
  • Equipment was maintained and serviced appropriately, and the environment was visibly clean.
  • Risks to patient were identified and assessed effectively. This was supported by robust safety processes.
  • Staffing levels and skill mix were planned and reviewed appropriately to ensure patients received safe care at all times.

However:

  • Not all staff were bare below the elbows while in the clinical area.

Effective

Updated 23 April 2019

We do not rate effective, but we found:

  • Care and treatment was delivered in line with current legislation and nationally recognised evidence-based guidelines. Policies and guidelines were developed in line with national guidelines and legislation.
  • The service paid due care to patients’ pain and provided adequate refreshments for the time they used the service.
  • The service worked well with internal colleagues, and external stakeholders such as GPs, NHS hospitals and the host hospital.
  • Staff had the skills and experience to safely perform scans on patients. Staff were encouraged and given opportunities to develop.
  • Staff were aware of how to seek consent from patients and consent was sought during the patient safety questionnaire for all patients.
  • The MRI unit was open weekdays between 7.30am to 6.30pm. There were plans to extend opening hours by one hour daily and to open on Saturdays as per demand.

However:

  • Not all staff had received a yearly appraisal.

Caring

Good

Updated 23 April 2019

We rated caring as

Good

because:

  • People were treated with dignity, respect and kindness during all interactions with staff. Patients told us their relationships with staff were positive. The service made sure that staff had the time, information and support they need to provide care and support in a compassionate and caring way.

  • The service provided sufficient time for staff to develop trusting relationships with people, their families, friends and other carers. Staff noticed when people were in discomfort or distress and took swift action to provide care and support.

Responsive

Good

Updated 23 April 2019

We rated responsive as

Good

because:

  • People’s needs were met through the way services were organised and delivered.

  • People’s individual needs were identified and their choices and preferences were provided for.

  • Patients had timely access to diagnostic imaging scanning. The service was responsive to urgent referrals.

  • The service used the learning from complaints and concerns as an opportunity for improvement. Staff could give examples of how they incorporated learning into daily practice.

Well-led

Good

Updated 23 April 2019

We rated well-led as

Good

because:

  • Leaders had the skills, knowledge and experience to manage the service.

  • The provider had a clear vision and a set of values, with quality and safety as the top priorities.

  • The service had a positive culture that was person-centred, open, inclusive and empowering. Leaders, managers and staff had a well-developed understanding of how they prioritised safe, high-quality, compassionate care.

  • There were governance frameworks that supported the delivery of good quality care. The service undertook quality audits, and information from these assisted in driving improvement and giving all staff ownership of things that had gone well. Action plans were identified on how to address things that needed to be improved.

  • Management systems could identify and manage risks to the quality of the service. The service used the information to drive improvement within the service.

  • Electronic patient records were kept secure to prevent unauthorised access to data. Authorised staff demonstrated they could be easily accessed when required.

  • There was a strong focus on continuous learning and innovation. Leaders, managers and staff considered information about the service’s performance and how it could be used to make improvements and improve innovation within the service.

However:

  • We found policies that were outdated and in need of review.
  • There was no local risk oversight that was reviewed regularly and assured adequate responsibility, accountability and an effective management of risks at a local level, except for the fire and MRI risk assessments.

  • The service was in the process of embedding a formalised staff appraisal programme, but this fell below the expected standard of 100% completion.

Checks on specific services

Diagnostic imaging

Good

Updated 23 April 2019

The provision of MRI scanning services, which is classified under the diagnostic imaging and endoscopy core service was the only core service provided at this service. We rated this core service as good overall.