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Inspection carried out on 14 August 2019

During a routine inspection

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

Vascular Department is based in a dedicated area of the host trust and provides vascular ultrasound services for adults and very rarely children and young people. The department has two scanning rooms, a waiting area and an office.

The department delivered approximately 6,000 scans in the period April 2018 to March 2019.

We inspected this service using our comprehensive inspection methodology. We carried out a short announced inspection on 14 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.

  • 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 integrity, 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.


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

Ann Ford

Deputy Chief Inspector of Hospitals (North)

Inspection carried out on 9 January 2013

During a routine inspection

Patients were referred to the Vascular Department by a consultant or specialist nurse, for diagnostic screening by ultra sound. Consent to care and treatment was already established as part of the individual patient's care pathway.

The service operated from one clinical room within the Ear, Nose and Throat Outpatients department on the 1st Floor of the Royal Bolton Hospital. When patients arrived they checked in at the reception and then were escorted to the clinical room.

We spoke with two patients during the inspection and comments included; "They explained everything to me and stopped me being worried" and "I wasn't a bit nervous, they were lovely, everything was done very professionally".

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, untoward incidents, performance rates and infection control.

The Vascular Department had appropriate guidance in place for staff in the event of any safeguarding incidents. We spoke with two staff and they were clear about what safeguarding incidents could occur and how these would be managed.