Beehive Solutions Limited

Beehive Solutions Limited is the name of the provider, registered location and service. The service provides non-obstetric and vascular ultrasound services to patients aged 17 and over. The service does not operate from fixed clinical premises and carries out procedures under contract from clinical commissioning groups (CCGs) and from rented space in GP practices. This was flexible and at the time of our inspection the service provided clinical services on one half-day per week. Staff use mobile ultrasound equipment, which they maintain and store.

We inspected this service using our comprehensive inspection methodology. Due to the nature of the service, we provided the clinical lead with short notice of our inspection. This was so that we could be sure the service would be operating on the day we inspected. We carried out the inspection on 14 March 2019 and 26 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.

The registered location is the provider’s head office and administrative centre. As part of our inspection we observed the service being delivered from a GP practice. The GP practice was not included in our inspection or ratings. We also visited the registered location to be able to speak with staff and obtain evidence for governance and equipment.

An ultrasound receptionist and service manager staff the head office five days a week, which is equipped to receive referrals, confidential patient information, the secure storage of scanned images and post-scan reports.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

We rated the service as Good overall.

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. The service had processes in place to manage safety incidents and to learn lessons from them.
• Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• The clinical lead ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

We found one area of outstanding practice:

• The service was highly responsive and was able to offer same-day, on-demand scans in any region it operated. This provided patients with an urgent need with a significant reduction in waiting times for a scan referral.

We found areas of practice that require improvement:

• In the GP practice the service was operating out of during our inspection, there was an unshaded skylight directly above the scanning monitor. This provided a sub-optimal view of the scanning screen and needed to be reviewed.
• Staff used probe covers that had expired in August 2016. This meant safety processes were not in place to ensure perishable stock was rotated and disposed of appropriately. After our inspection the registered manager disposed of old stock and obtained new probe covers for subsequent procedures.
• Staff did not always adhere to good infection control practices.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals