Chester Nuffield Alliance MRI Unit is operated by Alliance Medical. The service provides magnetic resonance imaging diagnostic scans on an outpatient basis. Facilities include a scanning room, control room, technical room, patient preparation area, two patient changing rooms and a toilet. The service also shares some facilities with a host hospital and healthcare provider including an administration office, a patient waiting area and a managers’ office.

The service provides diagnostic facilities to children and young people and adults. We inspected the service under our independent single speciality diagnostic imaging framework and using our comprehensive inspection methodology. We carried out an unannounced inspection on 31 July 2018.

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.

We rated it as good overall. This was the first time we had inspected this service.

We found good practice in relation to diagnostic imaging:

• There were effective systems in place to keep people safe from avoidable harm. Staffing was sufficient to keep people safe. Risks to patients was identified and assessed effectively, this was supported by robust safety processes. Equipment was maintained and serviced appropriately and the environment was visibly clean. Staff were compliant with infection prevention and control practices. Staff were trained and understood what to do if a safeguarding concern issue was identified. The service had good levels of compliance with mandatory training. Records were up to date and complete and kept safe from unauthorised access. Medicines were managed in line with best practice. Incidents were reported, investigated and learning was implemented.
• The service used evidence based processes and best practice, this followed recognised protocols. They used technology to improve the service they provided. The service paid due care to patients’ comfort and provided adequate refreshments for the time they used the service. Scans were timely, effective and passed back to refers to be reported on. There were no abandoned scans and no patients had to be recalled to repeat their scan. Staff were skilled and competent in their fields and kept up to date with their professional practice. The service worked well with internal and external colleagues and partnership working was strong. Staff understood their obligations regarding patient consent and the Mental Capacity Act.
• Staff demonstrated a kind and caring approach to their patients. Interactions were professional, respectful and courteous. Staff supported the emotional needs of patients and provided reassurance. Staff communicated well with patients, parents and carers and ensured their questions were answered. Patients’ information was kept safe and was treated confidentially.
• The service was planned with the needs of service users and partner organisations in mind. The facilities and environment were pleasant and suitable for use by patients. Appointments were also available during the evening. Appointments were available at short notice and the referral to scan times and scan to reporting times were brief. The service catered for nervous and anxious patients. The service had few complaints but acted upon feedback from patients, staff and incidents.
• The service was aligned to the vision and values of both partner organisations. They also had their own informal strategy to remain competitive and sustainable. The service had supportive, competent managers who led by example. Staff understood and were invested in the vision and values of the organisation. The culture was positive and staff demonstrated pride in the work and the service provided. Governance structures were robust. The service used performance data, learning from events and professional aptitude to improve quality, the patient experience and expand the service provided. Risks were identified, assessed and mitigated. Performance was monitored and data used to seek improvements. Information was utilised and managed well. Data was kept secure and was organised well to assist with management actions. Engagement with staff, stakeholders and partners was a strong feature of the service.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)