The Nottingham InHealth Specialist Imaging Centre (NISIC) is operated by InHealth. The service provides PET-CT (positron emission tomography–computed tomography) and diagnostic facilities for adults and children.

We inspected PET-CT diagnostic facilities for adults and children.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 22 October 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.

The main service provided by this unit was PET-CT.

Services we rate

We rated this service as good.

We found good practice in relation to diagnostic imaging:

• There were effective systems in place to keep people protected from avoidable harm.

• There were sufficient numbers of staff with the necessary skills, experience and qualifications to meet patients’ needs.

• There was a programme of mandatory training in key safety areas, which all staff completed, and systems for checking staff competencies.

• Equipment was maintained and serviced appropriately and the environment was visibly clean.

• Staff were trained and understood what to do if a safeguarding issue was identified.

• Records were up to date and complete and kept protected from unauthorised access.

• Incidents were reported, investigated and learning was implemented.

• The service used evidence based processes and best practice, this followed recognised protocols. Scans were timely, effective and reported on in timely way.

• Staff were competent in their field and kept up to date with their professional practice.

• The service worked well with internal and external colleagues and partnership working was strong.

• Staff demonstrated a kind and caring approach to their patients, supported their emotional needs and provided reassurance.

• Appointments were available at short notice if required.

• The referral to scan times and scan to reporting times were appropriate and well within expected ranges.

• The service had few complaints but acted upon feedback from patients and staff.

• 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.

• Risks were identified, assessed and mitigated. Performance was monitored and data used to seek improvements for both staff and patients.

• Engagement with staff, stakeholders and partners was a strong feature of the service.

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

• Medicines were not always managed in line with best practice. For example, medicine fridge temperatures were not monitored.

• Personal protective equipment was not always used as per InHealth policy and best practice. As a result, we were not assured that patients were protected from risk of cross infection.

• InHealth uniform policy was not always followed as staff were wearing unauthorised jewellery. As a result, we were not assured that patients were protected from a risk of cross infection.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)

We spoke with three patients. They told us they had received care in accordance with their needs. One patient said, “Very good. The procedure was explained to me and the scan was within five minutes of my appointment time.” Another patient said, “Very good. I was treated as a person, an individual.”

We found that patients received care that met their needs and that they were cared for in a clean, hygienic environment. However, we also found that patients, visitors and staff were not fully protected against the risk of unsafe premises.

We found that there were enough qualified, skilled and experienced staff to meet patients’ needs at all times. We also found that the provider took steps to assess the quality of the service being provided and that records were fit for purpose and kept securely.

We spoke with three patients. The patients we spoke with told us that they had received sufficient information before starting treatment with the service. They told us they could ask staff at any time if they had any questions and staff were helpful. One patient said, “The nurse explained exactly what was going to happen. Very good.”

Patients also told us they were treated with dignity and respect and their privacy was maintained. One patient said, “The care has been brilliant.” Another patient said, “Much better than I expected.” They told us they felt safe and staff appeared well trained and competent. One patient said, “The staff are very nice and caring. They treat you like you’re special.” Another patient said, “I felt in very good hands.”

We found that patients were treated with dignity and respect and received care that met their needs. We found that patients were safe and staff received induction, appraisal and training. We also found that the provider took steps to assess the quality of the service being provided.