Walsall MRI Centre is operated by InHealth Limited. Walsall MRI Centre delivers Magnetic Resonance Imaging (MRI) scans to people within the setting of Walsall Manor Hospital. Walsall MRI Centre originally opened in 1998 and has recently secured a 15 year contract with a local NHS Trust. At the time of our inspection the unit had recently been refurbished to include a new layout and two new MRI scanners.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 09 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.

We rated this service as good overall. We rated it good for safe, caring, responsive and well-led. We do not currently rate the effective domain.

Our key findings are as follows:

• Premises and equipment were appropriate and well maintained for the service provided. The service had recently undergone refurbishment and two new MRI scanners had been purchased.

• Comprehensive risk assessments were completed for patients and their chaperones before they were permitted into the unit. These were recorded on a safety questionnaire and stored in patient records.

• Staffing levels and skill mix were planned and reviewed appropriately to ensure patients received safe care at all times.

• Electronic systems were used to enhance the delivery of effective care and treatment. Scans were stored electronically and could be accessed by staff in the host hospital to speed up diagnosis and treatment times.

• The service undertook audits to monitor the effectiveness of the scans. For May, June and July all but one scan was found to be of a good standard. From April to September 0.02% of scans completed resulted in a recall.

• Staff displayed an understanding of patients personal, cultural and religious needs.

• Staff took their time with patients and allowed them to receive care at a comfortable pace.

• Patients were allowed to have people in the scanning room with them if they wanted.

• People could book in appointments at a time or day to suit them. Appointment slots were kept free for patients in the host hospital and emergency appointments.

• The facilities were appropriate for the service that was delivered. The service had recently undergone a refurbishment and redesign and was custom built to meet the needs of staff and patients.

• The new MRI scanners were suitable for bariatric (heavier) patients with the widest scanner opening available for use in acute hospitals.

• The service met 100% of their targets for routine and urgent referrals.

• Leaders had the skills, knowledge, experience, and integrity they needed to ensure the service met patient needs.

• Staff told us management were approachable and could raise any concerns they had. We observed friendly and professional interactions between management and staff.

• The service had access to both the InHealth and host hospitals computer systems. This allowed referrals to be made electronically from the host hospital and scan results be available immediately for radiologist review.

• Staff were actively engaged and told us they felt listened to. This was evident with the design of the new department.

However, there were areas where the service needs to make improvements:

• During our inspection we found medicines cupboards with the keys in which could have resulted in medicines being stolen or tampered with.

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. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

During this visit we reviewed five outcomes which we have found to be compliant. We found that people's needs and risks had been assessed and treatment planned and delivered in line with their needs.

We spoke with two people who used the service on the day of our inspection. Both people we spoke with told us that the staff had treated them with dignity and respect and had been very kind and helpful to them. We also gathered further evidence of people's experiences from completed satisfaction surveys that had been carried out by the service. One of the comments we read said, “I was very anxious and upset but ‘X’ (name of staff) helped me and put my mind at rest”.

We found that people who used the service were given appropriate information and support regarding their treatment. Both people we spoke with told us that staff had provided them with sufficient information to help them understand what would happen during the procedure. One person told us the staff were, "Very good I felt better when I could hear his (Staff member) voice".

We saw systems in place to protect people from abuse and discussions with the imaging services manager confirmed she knew who to approach and what to do should there be any concerns in this area.

We found that the provider had robust systems in place to monitor the quality of services they delivered to people who used the Centre.

We spoke with a couple of patients throughout our visit and observed the care and support they received whilst at the centre.

We observed people to be put at ease, to be reassured and unrushed. One person we spoke with told us how she felt the service was individualised to her and although she was aware that other people were due to have a scan she didn't feel rushed by the staff team.

People do not wait long for an appointment and the staff were observed to be accommodating, friendly and pleasant throughout our visit. We observed people's privacy and dignity being maintained during their time at the centre.

People felt they were kept well informed about the procedure encouraged throughout the procedure.