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Inspection Summary


Overall summary & rating

Good

Updated 29 January 2019

The Radiology Clinic is operated by Central Birmingham Imaging Solutions Limited. The service does not have overnight beds but provides outpatient diagnostic services. Facilities include one x-ray room, one ultrasound room, one consultation room and office, and two changing cubicles.

The service provides diagnostic imaging, and we inspected diagnostic imaging during this inspection.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced part of the inspection on 23 November 2018, along with an announced visit to the service on 30 November 2018.

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 rated the service as Good overall.

We found good practice in relation to diagnostic imaging:

  • Staff understood how to protect patients from avoidable harm and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The service controlled infection risk well. Staff kept themselves, equipment and the premises visibly clean. They used effective control measures to prevent the spread of infection.

  • The service had suitable premises and equipment and looked after them well.

  • The service had enough staff with the right qualifications, skills, training and clinical 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. Records were clear, up-to-date and easily available to all staff providing care.

  • Staff cared for patients with compassion.

  • Feedback from patients confirmed that staff treated them well and with kindness.

  • The service planned and provided services in a way that met the needs of local people.

  • The service took account of patients’ individual needs.

  • People could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

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

  • The service engaged well with patients, staff, the public and local organisations 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 in diagnostic imaging:

  • The service did not have formalised processes in place to support staff to raise safeguarding concerns.

  • The service did not have effective systems to make sure staff were competent for their roles.

  • Managers in the service did not always have the right skills and abilities to run a service providing high-quality sustainable care.

  • Systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected were not embedded.

  • The service did not have an embedded governance structure in place that was effective in systematically improving service quality and safeguarding high standards of care.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

Deputy Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 29 January 2019

  • The service made sure all staff had up to date mandatory training.

  • Staff understood how to protect patients from avoidable harm and abuse. Staff had training on how to recognise abuse and they knew how to apply it.

  • The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.

  • The service had suitable premises and equipment and looked after them well.

  • Staff completed risk assessments for each patient. They kept clear records and asked for support when necessary.

  • The service had enough staff with the right clinical 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. Records were clear, up-to-date and easily available to all staff providing care.

  • The service followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right dose at the right time.

  • The service managed patient safety incidents well. Staff recognised what constituted an incident and knew how to report them. The service had policies and procedures in place to support the investigation of, and sharing learning from, incidents.

However, we also found the following issues that the service provider needs to improve:

  • The service did not have formalised processes in place to support staff to raise safeguarding concerns.

  • The service did not audit clinical compliance or quality, including medicines audits, hand hygiene and infection prevention and control audits and World Health Organisation (WHO) completion audits.

Effective

Updated 29 January 2019

Caring

Good

Updated 29 January 2019

  • Staff cared for patients with compassion and dignity.

  • Feedback from patients confirmed that staff treated them well and with kindness.

  • Staff provided emotional support to patients to minimise their distress.

  • Staff involved patients and those close to them in decisions about their care and treatment.

Responsive

Good

Updated 29 January 2019

  • The service planned and provided services in a way that met the needs of local people.

  • The service was working closely with other local providers of healthcare to provide a joined-up approach to diagnostic imagery.

  • The service took account of patients’ individual needs, meeting the requirements of the Equality Act 2010.

  • People could access the service when they needed it. The service met its target to offer all patients an appointment within two weeks of referral. The service had no waiting list at the time of inspection.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Well-led

Requires improvement

Updated 29 January 2019

  • Managers in the service did not always have the right skills and abilities to run a service providing high-quality sustainable care.

  • The service did not have a formalised strategy in place to monitor progress against the vision.

  • Systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected were not embedded.

  • The service did not have an embedded governance structure in place that was effective in systematically improving service quality and safeguarding high standards of care.

However, we also found the following areas that the service was doing well:

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

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

  • 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, staff, the public and local organisations 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.
Checks on specific services

Diagnostic imaging

Good

Updated 29 January 2019

The service has been registered with CQC since July 2017 and operates from a shared occupancy building in Edgbaston, Birmingham. The service provided imaging services, specifically x-ray and ultrasound, for adult patients aged over 18 years. The location had one x-ray room, one ultrasound room, two changing cubicles and an office, also used as a consulting room.

The service treated 356 patients between November 2017 and October 2018, all of which were privately funded. The service did not currently undertake NHS work.