When we last visited the provider in February 2014 we found the service was non-compliant with safeguarding (regulation 11, outcome 7) and requirements relating to workers (regulation 21, outcome 12) so we returned to check to see if improvements had been made.

During the follow-up inspection in August 2014 we found the necessary improvements had been made. Safeguarding processes had been revised and staff had access to an up-to-date safeguarding policy which included key contact information if concerns needed to be raised. There were also controls in place via an external recruitment agency which ensured agency staff were up-to-date with safeguarding and other necessary training.

Recruitment processes had also been reviewed and processes were in place to ensure new staff were suitably skilled and qualified, including obtaining references, before being offered a contract of employment. All staff, including agency staff, were also required to complete an induction which ensured people were aware of company polices and processes.

We spoke with two people during the inspection who had been scanned on the mobile unit. One person we spoke with described how things had been fine and staff were lovely. They also stated they felt safe and things were explained well. The second person we spoke with commented that staff had been fine and there were no problems; they said they were also treated respectfully.

SG Radiology Associates Ltd is operated by SG Radiology Associates Ltd.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on the 5 and 6 February 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.

Services we rate

We rated this service as Good overall.

We found good practice in relation to:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• Staff understood how to protect patients from abuse and when to contact other agencies to do so.

• The service had suitable premises and equipment and looked after them well.

• Staff completed risk assessments for each patient.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment

• The service provided care and treatment based on national guidance and evidence of its effectiveness, monitored the effectiveness of care and treatment and used the findings to improve them.

• The service made sure staff were competent for their roles and staff worked together as a team to benefit patients.

• Staff understood their roles and responsibilities under the Mental Capacity Act 2005 and in relation to informed consent.

• Staff cared for patients with compassion and provided emotional support to patients to minimise their distress. Feedback from patients confirmed that staff treated them well and with kindness.

• 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.

• The service took account of patients’ individual needs and people could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice

• The service investigated incidents and complaints, learned lessons from the results, and shared these with all staff.

• The service had a vision for what it wanted to achieve and workable plans to turn it into action.

• Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

• The service collected, analysed, managed and used information well to support its activities, using secure electronic systems with security safeguards.

• The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.

• The service was committed to improving services.

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

• We did not see any evidence that staff hand hygiene or cleanliness of the mobile units was audited.

• The service did not have a system in place for receiving and cascading medical device alerts or patient safety alerts from the Central Alerting System to staff.

• There were indications that there may be some under-reporting of incidents which meant there were missed opportunities for learning and improvement.

• Local Rules were not available for staff reference at the point of care.

• The service did not have a consistent process of their own for dealing with language needs as they could access interpreting services when situated at a hospital site but not when at a community site.

• Although the service identified risks well, planned to eliminate or reduce them, and cope with both the expected and unexpected, there was not a framework around this to help with consistent management, documentation of mitigations or easy oversight and review.

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

Ellen Armistead

Deputy Chief Inspector of Hospitals (North Region)