Background to this inspection
Updated
21 June 2019
Veincentre Manchester is based in a period building in the city centre of Manchester. The clinic has recently been renovated and is designed to meet its specific needs. The service is registered with CQC under the Health and Social Care 2008 to provide the following Regulated Activities:
Diagnostic and screening procedures
Surgical procedures
Treatment of disease, disorder or injury
Veincentre Limited is the service provider. Clinics are also provided at other sites based in Bristol, London, Stoke, Newcastle Under Lyme, Nottingham and Oxfordshire. The services are provided to adults privately and are not commissioned by the NHS.
Veincentre Manchester provides consultations, ultrasound scanning and minimally invasive treatment procedures to improve the appearance of varicose veins. A range of treatments are provided based on the assessed needs of individual patients. These treatments include foam sclerotherapy where injections of a solution are made directly into the vein, avulsions where small incisions are made in the skin and the vein removed and endovenous laser ablation (EVLA) a laser treatment carried out under local anaesthetic. The premises have been specifically designed for the treatment and comprises of consultation rooms, a minimally invasive operating theatre/recovery area and a reception area. The clinic is located on the fourth floor of the building which is easily accessed by lifts and accessible corridors.
Office hours (based in the head office at Stoke) are between 9am and 5.30pm Monday to Wednesday and 9am and 6pm Thursday and Friday. Subject to consultant annual leave, clinics are provided at this location (Manchester) on a Monday, Thursday and Fridays between 10.30am and 5pm. Appointments can be booked face to face, over the telephone or by email. Patients are usually seen within three weeks of their initial enquiry although additional clinics can be provided if demand exceeds this. Patients with urgent symptoms are prioritised. The service has an out of hour’s emergency telephone line providing direct contact to a consultant.
The staff team at the Manchester clinic consists of one consultant vascular surgeon, two consultant interventional radiologists, a nurse practitioner and receptionist supported centrally by a business director, director of strategy, medical secretary and a further range of reception and administrative staff.
How we inspected this service
Our inspection team was led by a CQC lead inspector. The team included a specialist adviser.
Before visiting we reviewed a range of information we hold about the service and asked the service to send us a range of information. This included the complaints they had received in the last 12 months, their latest statement of purpose, the details of their staff members, their qualifications and proof of registration with their professional bodies. As part of the inspection we spoke with a range of staff including the medical director/registered manager, business director, a nurse practitioner and receptionist. We gained feedback from seven patients, carried out observations and review of documents.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
21 June 2019
This service is rated as Good
.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Veincentre Manchester (St Anne Street) as part of our inspection programme. The service has not previously been inspected.
Veincentre Manchester is based in Manchester city centre and provides a specialist non-surgical diagnosis and treatment of adults suffering from venous insufficiency, a condition that occurs when the venous walls or valves in the leg veins are not working effectively. The clinic is owned and managed by Veincentre Limited, which was established in 2003 by a consultant interventional radiologist and provides consultations, ultrasound scanning and minimally invasive treatment procedures to manage symptoms, treat complications of venous insufficiency and improve the appearance of varicose veins.
Dr David West is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Feedback received through seven completed CQC comment cards described the service as very good, that they received good explanations and that everyone was kind and friendly. We did not speak to any patients on the day. Staff we spoke with told us they were well supported in their work and were proud to be part of a team which provided such a high quality, specialised service.
Our key findings were:
- Patients received detailed and clear information about their proposed treatment which enabled them to make an informed decision. This included costs, risks and benefits of treatment.
- Patients were offered appointments at a time convenient to them and with the same clinician to ensure their continuity of care and treatment.
- Patients’ needs were fully assessed, and care and treatment were tailored to individual needs.
- Clinicians assessed patients according to appropriate guidance, legislation and standards and delivered care and treatment in line with current evidence-based guidance.
- There was a transparent approach to safety with demonstrably effective systems in place for reporting and recording adverse incidents.
- There were effective procedures in place for monitoring and managing risks to patient and staff safety. For example, there were arrangements in place to safeguard people from abuse, and to ensure the premises were safe for patient, staff and members of the public.
- Staff were supported both personally and professionally and received opportunities for supervision, training, coaching and mentoring appropriate to their role.
- Patients told us staff were kind, caring, and put them at ease and maintained their dignity.
- Information about services and how to complain was available and easy to understand.
- There was a clear staffing structure and staff were aware of their own roles and responsibilities.
- The provider was aware of, and complied with, the requirements of the Duty of Candour.
We saw the following outstanding practice:
Veincentre Manchester delivers a super specialist service to treat varicose veins. (A super specialist is a sub-specialist who has self-limited their practice to one aspect of a sub-specialty). This single disorder management enables more efficient working and delivery of care and treatment by clinical staff who are highly trained, supervised, coached and mentored. They have a patient safety management system targeted to the speciality of vein disorder and are the largest contributor of data to an international audit process.
Data showed to us by the service demonstrated lower complication rates for the most common complications of vein treatment when compared to national thresholds.
The areas where the provider should make improvements are:
- Review the documentation of water temperatures in response to the legionella risk assessment.
- Review the documentation of the induction process and ensure it includes all necessary induction including management of medical emergencies.
- Review the training programme to ensure all staff receive training and updates in medical emergencies.
- Review the emergency medicines held at the clinic and develop a risk assessment for those considered not necessary to be kept on site.
Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care