Alliance Medical Marylebone

Alliance Medical Imaging Centres - Bulstrode Place is a diagnostic imaging service based in central London operated by Alliance Medical Limited. Facilities were split across five floors and included diagnostic imaging and control rooms, consultation rooms, patient preparation areas, changing rooms, reception and waiting areas, and office space.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 29 March 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.

The main service provided by this centre was diagnostic imaging.

Services we rate

This the first time this service has been rated. We rated it as good overall.

• The service environment was clean and well maintained. There were comprehensive infection prevention and control processes in place.
• The service had enough staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
• Staff completed and updated risk assessments for each patient. Patient records were clear, up-to-date and easily available to all staff providing care.
• The service made sure staff were competent for their roles. Mandatory training in key skills was provided to all staff and made sure everyone completed it.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately, and any incidents were investigated thoroughly.
• The service provided care and treatment based on national guidance and evidence of its effectiveness.
• Managers monitored the effectiveness of care and treatment and used the findings to improve them.
• Clinical staff supported each other to provide good care. There was a good relationship between the various staff disciplines.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. During the inspection we saw staff treating patients with dignity, kindness, compassion, courtesy and respect.
• Staff involved patients and those close to them in decisions about their care and treatment.
• The service planned and provided services in a way that met the needs of local people. Patients could choose an appointment times that best suited them.
• The provider’s website provided useful information about the service, staff, procedures that were provided, and the referral process.
• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
• Patients with complex needs would be provided with more time for an appointment and could also be supported in their appointment by a family member.
• The service had a clear management structure. Staff told us the clinical leads were approachable and supportive, and that they could reach them when needed.
• Staff were very positive and happy in their role and stated the service was a good place to work. Staff told us they felt supported, respected and valued.
• We reviewed team meetings minutes and saw they discussed complaints, incidents, Key Performance Indicators (KPIs), training, compliance and any other clinical issues.
• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.
• The service had a business continuity policy, which included specific plans for the service. This plan was in action at the time of us visiting the service due to a power outage in the area, and we saw that the impact to service delivery was well controlled.

However:

• On inspection we identified a room that had a number of fire hazards. This included exposed electrical wiring next to flammable materials, which were not safely stored. Following inspection, the service sent us evidence that this had been addressed sufficiently.
• We observed some electrical equipment which displayed expired electrical testing (PAT).
• Although the service had policies and guidelines in place, staff could not locate guidance relating to IR(ME)R regulations when asked. This meant it may be difficult to locate the correct procedures or guidance when needed.
• The service provided disability access for patients with limited mobility at the back of the building. However this access had a steep incline into the building and we did not see evidence that this had been appropriately risk assessed.
• On inspection we identified a number of risks which had not been identified on the service risk register.
• The registered manager for the service was not sure as to how issues identified as risks were added to the risk register. This meant that some risks identified locally may not be monitored in line with the provider's risk management procedures.
• The service did not have a specific vision or strategy document.
• Some staff stated that they felt the culture regarding reporting incidents could be improved.

Nigel Acheson

Deputy Chief Inspector of Hospitals