We met with two members of staff and spoke to one service user.

We saw that the clinic was situated on the ground floor of an old property in a central location. We saw that there was limited, but adequate parking. We saw there was a ramp to enable people in wheelchairs to easily access the clinic.

We saw that the reception area was staffed and people were greeted in a friendly way. The waiting area was light and in good decorative order. We saw that there were adequate toilet facilities available.

People told us that they were able to have an appointment at a time that was convenient. We were told that the clinic opens approximately three days a month and weekdays only.

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We saw that the space for the clinic was limited and the treatment area was small but adequate. There was no access to fresh air in the staff area nor the treatment room. People receiving care did not identify that as a concern.

One person attending the clinic told us that they felt respected by staff and that staff had taken time to show them their scans and explain things to them which they found helpful. We observed staff talking about service users in a professional and respectful way.

We saw that there were governance and quality assurance arrangements in place to audit and review clinical and quality outcomes. Also that people's views were sought and changes had been made as a result of comments made.

Cavendish Imaging Oxford is operated by Cavendish Imaging Limited. It provides a private scanning service for patients as part of planned dental work, often for dental implants. The service is on the ground floor and occupies a room within a building used by healthcare professionals. The service’s single, combined imaging unit is in a small room in the core of the building, with an adjacent administration area. There is a shared reception area and waiting room, also on the ground floor. There are no overnight beds.

The service provides imaging services for adults, young people and children. It is open approximately four days a month.

We inspected this service using our comprehensive inspection methodology. We carried out the short-notice announced inspection (48 hours) on 21 September 2018. The unit was not operational on the day of our visit, and after our site inspection we gained consent from recent patients to telephone and ask them about their care.

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 was diagnostic imaging.

Services we rate

We rated it as good overall.

• The provider established safe systems for delivering imaging services at this unit. For example, it recruited registered radiographers to deliver the imaging services, and checked their competencies and skills regularly through a systematic appraisal and training programme. Data was stored and transferred securely, using protected, electronic platforms.

• A key aim for the service was to provide a caring, patient-focused service, and the provider sought feedback from patients to help identify improvements. Patients said they were treated with kindness and staff were professional and courteous.

• Staff were aware of policies and procedures for delivering safe care, including those relating to safeguarding adults and children.

• The imaging equipment was maintained and safety tested and the Local Rules defined safe operating procedures.

• There was appointed and accessible safety staff; the radiation protection supervisor, radiation protection advisor and the medical physics expert. The radiographer at the Oxford service was the provider’s infection control lead, and was supported to develop this role. There was an audit programme that included image quality control assessments, health and safety and infection control audits.

• The provider’s policies and procedures were aligned to the Ionising Radiation (Medical Exposure) Regulations, to promote safe practices.

• There was clear leadership of the service and staff felt supported and able to raise concerns. Issues were reviewed for learning and to improve practices, and staff had regular meetings. These were used for staff to discuss areas for improvement, celebrate successes and learn about any company changes.

• The unit was located on the ground floor and accessible to people in wheelchairs and for those with a hearing impairment. Patients attended pre-booked appointments, and there was no waiting list.

However, we also found the following issues that the service provider should improve:

• The provider should ensure that patients have access to the complaints process.
• The provider should ensure patients receive information in advance about what to expect.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)