8 January 2019
During a routine inspection
Yorkshire Clinic Imaging Centre is part of Alliance Medical Limited group. Yorkshire Clinic Imaging Centre is situated within an independent hospital for which it provides diagnostic imaging services. This includes Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) services
The service also provides a CT colonography service with rectal cannulation undertaken by a Gastrointestinal (GI) consultant radiologist. The service also used radiographers to complete this service. The radiographers were trained to complete this and worked under the supervision of GI consultant radiologists.
Yorkshire Clinic Imaging Centre’s diagnostic imaging services were inspected using our comprehensive inspection methodology. We carried out an unannounced visit to the hospital on 8 January 2019 and telephone interviews with staff on the 17 January and 11 February 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 rated this service as Good overall.
We found good practice in relation to diagnostic imaging:
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Managers had the right skills and abilities to run the service and staff described a positive culture where managers, staff and the multi-disciplinary team worked well together. The service ensured staff were competent with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. Managers appraised staff’s work performance as a means of development.
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The service had suitable premises and equipment and looked after them well. Equipment and premises were visibly clean, and staff used control measures to prevent the spread of infection.
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The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards. Patients records were clear, up-to-date and available to all staff providing care.
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The service systematically improved service quality and safeguarded high standards of care. Patient safety incidents were well managed, and staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. Staff of different kinds worked together as a team to benefit patients.
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The service treated concerns and complaints seriously, investigated them, learned lessons from the results, and shared these with all staff.
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Staff cared for patients with compassion, provided emotional support to minimise their distress and involved patients and those close to them in decisions about their care and treatment. Feedback from patients confirmed that staff treated them well and with kindness.
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Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Policies and procedures were implemented when a patient could not give consent.
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The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively.
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The service planned and provided services that met and took account of the individual needs of local people. Care and treatment was based on national guidance and evidence of its effectiveness and managers checked that staff followed this guidance.
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People could access the service when they needed it. Waiting times from referral to scan were in line with good practice.
However, we also found the following issues that the service provider needs to improve:
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Documentation of daily checks of the warming equipment had not taken place.
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Authorising signatures for patient group directions (PGD’s) were not present against the PGDs.
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The Alliance Medical Limited medicines management policy (v2.4) was overdue for review. However, the provider has recently informed us that a dual policy agreement existed with the local hospital healthcare provider. The service worked to the healthcare providers medicines management policy which was reviewed in October 2018.
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The keys to the medicine’s cupboard were kept in the medicine cupboard door in the control room. However, access to the control room was not restricted which meant unauthorised access to medicines could occur.
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Checks and administration of contrasts to patients were not always completed by two trained staff
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Ellen Armistead
Deputy Chief Inspector of Hospitals (Hospitals)