Archived: Fastrack Scan

Updated 13 January 2021

Fastrack Scan is operated by Ecospirito Ltd and provides a dual energy x-ray absorptiometry (DEXA) scanning service from a mobile unit. The majority of patients are referred from an independent hospital group based in the East of England, but the service also sees self-funded patients and private clients.

At the time of our inspection, the service had a registered manager in post, who had been in position since their initial registration with CQC in May 2018, and was registered to undertake the following regulated activities:

• Diagnostic and Screening Procedures

We last undertook a comprehensive inspection of this service on 2 April 2019. Following this, we rated the location as inadequate overall. As the service was not meeting the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, we issued the provider with two requirement notices relating to breaches of Regulations 11 and 17. Following this inspection, we made the decision to suspend the service for a period of eight weeks, due to concerns patients may be exposed to risk of harm. We also took action to place the provider into special measures.

We undertook a focused inspection on 29 May 2019 to follow up these concerns. Whilst the service had made some improvements, there was continued non-compliance in a number of areas, including significant concerns with governance. The service remained rated as inadequate and stayed in special measures. Following this inspection, we told the provider they must take actions to improve and issued a warning notice in relation to governance.

To check whether the service had addressed these concerns, we conducted a short-notice announced inspection on 6 November 2020, which we followed with interviews with both the registered manager and the radiation protection supervisor on 13 November 2020. These interviews were conducted remotely due to the ongoing COVID-19 pandemic at the time of our inspection. Following this inspection, we found that the provider was still non-compliant in some of the areas previously identified. The significant improvements required had not been made and the provider remains rated as inadequate. The regulatory action section at the end of this report details the legal requirements the provider did not meet.

Updated 13 January 2021

We inspected Fastrack Scan because at our last inspection, we rated the location as inadequate and placed the provider in special measures to help it improve.

Our rating of this service went down. We rated it as inadequate overall as we rated safe, responsive and well-led as inadequate. We do not rate the effectiveness of diagnostic imaging services and we did not inspect caring as part of this inspection.

During our inspection we found:

• The service did not have staff with the necessary skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Not all staff had completed mandatory training, which included basic life support. Not all staff had undertaken safeguarding training appropriate to their role.
• The design, maintenance and use of facilities did not always keep people safe, as not all equipment had been serviced and staff did not manage clinical waste well. The service did not always use effective control measures to protect patients, staff and others from infection.
• The service did not manage patient safety incidents well. There was no clear process for reporting, managing or investigating incidents, or for the sharing of lessons learnt with the team. Managers did not ensure that actions from patient safety alerts were implemented or monitored.
• The service did not always provide care and treatment that was based on national guidance or evidence-based practice. There were no processes in place to ensure staff followed up-to-date guidance. Staff did not monitor the effectiveness of care and treatment, and therefore could not use the findings to make improvements and achieve good outcomes for patients.
• The service did not make sure all staff were competent for their roles. Managers did not appraise staff’s work performance and did not hold supervision meetings with them to provide support and development.
• It was not easy for people to give feedback and raise concerns about the care received. There were no robust processes in place for investigating complaints and sharing lessons learnt.
• Leaders did not have the skills and abilities to run the service. They did not understand or manage the priorities and issues the service faced. Leaders did not operate effective governance processes, either throughout the service or with partner organisations. Staff were not clear about their roles and accountabilities, due to a lack of robust governance and oversight procedures. Staff did not have regular opportunities to meet, discuss and learn from the performance of the service.
• The service did not have a vision or strategy for what it wanted to achieve.
• Leaders and teams did not use systems to identify and manage risks to patients and the service. They did not identify or escalate relevant risks and issues, nor identify actions to reduce their impact.
• The service did not collect reliable data and analyse it to understand performance, make decisions and drive improvements. Personal information was not processed in line with data protection guidelines.
• Leaders and staff did not engage with patients, staff, equality groups or the public to plan and manage services.
• Staff were not always committed to continually learning and improving services. They did not have a good understanding of quality improvement methods and the skills to use them.

However:

• Key services were available seven days a week to support timely patient care. The service planned care to meet the needs of local people and the communities served, and people could access the service when they needed it.
• Staff followed guidance to gain patients’ consent prior to undertaking any scan. Staff ensured patients understood the radiation risks associated with the scan.

Following our inspection, we took enforcement action against the provider due to continued non-compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which included Regulations 12, 13, 17 and 18. This enforcement action included the cancellation of the provider's registration and the registered manager's registration with CQC, which resulted in the provider no longer being registered to undertake their regulated activities, diagnostic and screening procedures.

Updated 13 January 2021

Our rating of this service went down. We rated it as inadequate overall as we rated safe, responsive and well-led as inadequate. We do not rate the effectiveness of diagnostic imaging services and we did not inspect caring as part of this inspection.