14 May 2019
During a routine inspection
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