The Care Quality Commission (CQC) has told Mediscan Diagnostic Services Limited that it must make urgent improvements to the quality of its diagnostic and screening core service in its Manchester location and also to the Mediscan Centre in Oldham.
CQC carried out an unannounced focused inspection of the services in April after receiving information of concern about the safety and quality of the services.
Inspectors visited the main locations based in Manchester and Oldham, as well as some of the five satellite clinics based in Ashton Under-Lyne, Middleton, Heywood, Cheetham Hill and the mobile endoscopy unit in Bradford.
Inspectors have rated both locations inadequate overall. Following the inspection, CQC imposed urgent conditions upon the provider. These were that the provider must not carry out any invasive diagnostic procedures involving the insertion of instruments into the body including but not limited to all types of endoscopy gastroscopy, colonoscopy and all invasive ultrasound scans.
The second part of the urgent conditions required improvements in infection prevention and control, equipment maintenance, staff competencies, leadership and governance and management systems.
Mediscan Diagnostic Services Limited delivers a range of services including ultrasound scanning, endoscopy procedures including sigmoidoscopy, colonoscopy and gastroscopy, audiology and physiotherapy.
CQC’s chief inspector of hospitals, Ted Baker, said:
“At the time of our inspection of Mediscan Diagnostic Services Limited, we found a number of serious concerns relating to patient safety. To ensure the provider focusses their attention on the areas of improvement we identified, we have imposed urgent conditions upon the location.
“Inspectors saw staff providing ultrasound scans in the clinics wearing aprons and masks. However, they did not see that staff changed personal protective equipment between patients which is an infection risk.
“We found unsafe equipment, equipment which had exceeded its re-test date and electrical equipment which had not been safety tested which could result in patient harm.
“Following our inspection, we gave Mediscan feedback of our findings, and made clear those concerns which required an urgent response. Mediscan Diagnostic Services Limited knows what it must do to ensure it improves its services.
“In the meantime, we will work with local stakeholders and continue to monitor the service closely. We can confirm our inspectors returned to Mediscan Diagnostic Services Limited in June and will publish our findings in due course along with any further action we may have considered.”
Inspectors found:
- The service did not always control infection risk well. The infection control policy did not provide clear guidance for staff to follow in how to use equipment and control measures to protect patients. They did not always keep equipment and the premises visibly clean and monitoring processes were not robust
- The design, maintenance and use of facilities, premises and equipment did not always keep people safe and there was limited evidence that staff had received appropriate training in the use of equipment. The service did not have robust systems in place for the oversight of equipment maintenance and we found equipment that posed a risk to patients’ safety
- There was not a robust process in place for the oversight of staff resuscitation training and the policies in place for staff to follow in respect of deteriorating patients were not fully reflective of the service provided. Staff used early warning scores for patient observations on the endoscopy unit, however a review of records identified mixed adherence to the completion of these
- The service did not have robust systems and processes in place to safely prescribe, administer, record and store medicines in the diagnostic and screening core service
- There was limited access to policies and procedures for staff and managers did not always check to make sure staff followed guidance, there were limited evidence of audits undertaken by the provider
- The service did not always make sure that staff were competent for their roles there was limited evidence of staff competencies and required training compliance was low. Managers did not always appraise staff’s work performance or hold supervision meetings with them to provide support and development
- Patients were not always supported to make informed decisions about their care and treatment. Consent documentation did not always meet with national guidance and there was a lack of clarity about the consent process in the diagnostic and screening core service
- Leaders did not operate effective governance processes, throughout the service. Policies and procedures were not reflective of the services provided and so staff at all levels could not be clear about their roles and accountabilities
- Leaders did not always use systems to manage performance effectively. They did not have effective risk management processes in place to identify and escalate relevant risks and issues or identified actions to reduce their impact.
However, inspectors also found:
- Staff could describe how to identify and quickly act upon patients at risk of deterioration or those with unexpected findings
- The service provided care and treatment based on evidence-based practice
- Staff had regular opportunities to meet, discuss and learn.
You can read full details of the inspection on the CQC website:
Mediscan Diagnostic Services Limited
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