Standing CT Head Office

Updated 1 May 2019

Standing CT Head Office is operated by The Standing CT Company Limited. The service registered in June 2017, to provide mobile ‘cone beam computerised tomography’ (CBCT) to scan patient’s ankles and feet, whilst in a standing position. The CBCT scanner rotates and a series of X-rays are combined so the software can create different images. This technology permits scans while the patient is standing and bearing weight on their feet and ankles.

At the time of inspection, the company had one mobile unit and regular contracts with an NHS trust and a private acute hospital in Hertfordshire. The mobile unit was based at these two hospitals one day a week. It also provided services at a third hospital, on an ad hoc basis, in line with contracted arrangements. Almost all referrals were from these hospitals but the service also accepted patient referrals from outside the area.

The service’s current manager was registered with CQC in September 2018.

This inspection took place on 7 March 2019, and the inspection team visited the mobile scanning unit whilst it was parked at the NHS hospital.

Updated 1 May 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. We do not rate effective for diagnostic imaging services.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

This was the first time we had rated this service, and we rated it as Good overall.

We found the following good practices at this diagnostic and imaging service:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it. This included training in how to protect patients from abuse. Staff knew how to recognise and report abuse.

• The service controlled infection risk well and staff kept the equipment and premises clean. The premises and equipment were suitable and staff checked they were safe.

• Staff followed processes to ensure the right person received the right radiological scan at the right time.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm. Managers made sure staff had the skills needed to provide high-quality care. They supported staff with appraisals, and opportunities to update their skills.

• Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available and accessible to others involved in patient care. Staff sought patients’ consent for a scan and for holding personal information.

• The service had systems to manage patient safety incidents.

• The service provided care and treatment based on available guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance and monitored the effectiveness of care to improve outcomes for patients.

• Staff from different disciplines worked together to benefit patients. They supported each other so patients had no gaps in their care.

• The provider cared for patients with compassion. Feedback from patients we spoke with confirmed that staff treated them well and with kindness.

• Staff provided emotional support to patients to minimise their distress and involved patients and those close to them in decisions about their care.

• The service was set up to put patients at the heart of the services and to have a scan at the time of their outpatient consultant appointment.

• The service planned and provided services in a way that met the needs of people who used the service. The environment was appropriate for patients, including those with mobility or other individual needs.

• The service treated concerns and complaints seriously, investigated them and learned lessons from the results.

• Managers had the right skills and abilities to run a service providing high-quality sustainable care.

• The service had a vision for what it wanted to achieve and reviewed this based on patient feedback and local engagements with services.

• Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

• The service used a systematic approach to continually improve the quality of its services and safeguarding high standards of care.

• The service had identified risks and put in plans to eliminate or reduce them.

• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

• The service engaged well with patients to plan and manage appropriate services, and collaborated with partner organisations effectively.

• The service was committed to improving services by learning from when things went well or wrong, promoting training, research and innovation.

We found areas of practice that require improvement:

• The site survey risk assessment did not reflect the risks associated with parking the mobile unit in a temporary position at a host hospital.

• Although almost all the policies had been reviewed and updated, the radiation protection policy did not refer to the latest IR(MER)R legislation.

Following this inspection, we told the provider it should make improvements, even though a regulation had not been breached, to help the service improve.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)