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Inspection carried out on 5 August 2019

During a routine inspection

Vascular Services Department is operated by Independent Vascular Service Limited. The service opened in May 1999 and delivers vascular investigations to NHS trusts and independent hospitals. There are eight locations across the North West of England.

This service is based in a dedicated area of a local host trust along with other vascular services and provides vascular ultrasound services for adults. The service has three scanning rooms and a shared waiting area.

We inspected this service using our comprehensive inspection methodology. We carried out a short announced inspection on 5 August 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

We had not rated the service in previous inspection We rated it as Good overall.

This was because

  • Staff received and kept up-to-date with their mandatory training.

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.

  • The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.

  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.

  • Staff knew about and dealt with any specific risk issues.

  • The service had enough staff with the right qualifications, skills, training and experience to provide the right care and treatment.

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.

  • The service managed patient safety incidents well. Staff recognised incidents and near misses and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.

  • The service provided care and treatment based on national guidance and evidence-based practice. Managers checked to make sure staff followed guidance.

  • Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients. The service had been accredited by

  • Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

  • Staff gave patients and those close to them help, emotional support and advice when they needed it.

  • Staff made sure patients and those close to them understood their care and treatment.

  • Managers planned and organised services, so they met the changing needs of the local population.

  • The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.

  • People could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were better than national standards.

  • Staff understood the policy on complaints and knew how to handle them.

  • Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

  • The service had a vision for what it wanted to achieve and a strategy to turn it into action.

  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.

  • Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

  • Leaders and teams used systems to manage performance effectively.

  • The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure.

  • Leaders and staff actively and openly engaged with patients and staff.

  • All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them. Leaders encouraged innovation and participation in research.

    However

  • The service’s complaints policy did not set out the process for how self-funded patients could complain.

  • The service manager was unable to attend the multi-disciplinary team meetings as they took place on a different site. This meant that the service was not able to provide their views on complex patients.

Ann Ford

Deputy Chief Inspector of Hospitals (North)

Inspection carried out on 1 February 2013

During a routine inspection

Patient feedback was very positive about their experience the service they received. Patients were satisfied that their health care needs had been met and had been treated respectfully. A typical comment regarding their experience was: “We were in straightaway. In the past I've had to wait for a long time before being seen. Today was totally different. A very swift and effecticient way of doing things." We spoke to one patient and their family member directly, and they said they felt well informed about the services provided, and added that the staff were good at explaining what was going to happen and why.

The unit had procedures in place for dealing with allegations of abuse. Staff members spoken to said they would not hesitate to report any concerns they had to ensure people were protected from potential harm or abuse. It was clear from discussions with staff that they had a good understanding of safeguarding. They commented that they had confidence in the process they would follow if they had concerns about clinical practice or if issues had been disclosed to them.

There was a system in place to ensure appropriate monitoring of the quality of the service provided. Audits were undertaken and these included quality of scans, performance rates, untoward incidents and infection control issues.

Inspection carried out on 1 December 2011

During a routine inspection

Patients we spoke to were very positive about their experience of care and treatment. Patients said they had their care needs met and had been treated respectfully.

A typical comment of patient experience was

“There has been no waiting for care, treatment generally has been very good and staff are very caring.”

Patients we spoke to felt well informed on their diagnosis, treatment and prognosis. All patients interviewed said staff were good at explaining treatments and let them know what they were about to do prior to carrying it out.

For example people said

“They tell me what is happening, and what clinical procedures are being undertaken. I feel I can talk to anyone about my concerns. Enough information was given and I understood it.”

Patients confirmed to us that they knew they would be undergoing a scan before they reached the unit. They told us the staff explained to them what the investigation would be like before they started.

Patients told us:

“Staff are wonderful, they explained everything to me and stopped me being worried”

“Staff explained everything to me. They were very courteous and respectful. They always asked my consent before they did anything”