Warrington Community Ultrasound Service is operated by Kleyn Healthcare. The service provides ultrasound scanning diagnostic tests across several locations in the North West of England.

The service uses clinic facilities arranged through service level agreements with several host GP organisations in Warrington and Manchester. They have one registered location at The Medi Centre, 1 Tanners Lane, Warrington, WA2 7LY. This location is where the services are managed from.

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 22 January 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.

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

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 provide a safe and effective service. Risks to patients were identified and assessed appropriately, this was supported by effective 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 appropriate and were kept safe from unauthorised access. Incidents were reported, investigated and learning was implemented.
• The service used evidence based processes and best practice and these followed recognised protocols. The service monitored and audited their performance to identify if it met contract commitments and best practice. Scans were timely, effective and reported on the same day. 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 good. Staff understood their obligations regarding patient consent and the Mental Capacity Act.
• Staff demonstrated a caring and respectful approach to their patients. Interactions between staff and patients were professional and courteous. Staff were compassionate and supported the emotional needs of patients and provided reassurance. Staff communicated well providing good explanations in a way patients could understand and ensured patients’ questions were answered. Patients’ information was kept safe and was treated confidentially.
• The service was planned with the needs of patients, and stakeholders in mind. The facilities and environments in which patients were seen were suitable for the intended use. Appointments were available during the evening and weekends and at locations suited to patients’ needs. Appointments were available at short notice and the referral to scan times and scan to reporting times were brief. The service catered for patients’ individual needs. There were few complaints but the service acted upon feedback from patients, staff and incidents.
• The service was aligned to the vision of the organisation. The service had a strategy to develop and expand services and a vision of how they could remain competitive and sustainable and the service of choice based on knowing what the sector wanted.
• Managers were competent and passionate about the service and led by example. Staff understood the vision and values of the organisation and were committed to their work. The culture was positive and staff demonstrated pride in the service provided.
• Good governance structures were in place to enable managers to run the service effectively and efficiently. The service used performance data and their knowledge of the sector, to improve the experiences of patients and to continue to expand the services provided. Risks were identified, assessed and mitigated. Information was utilised and managed well and data was kept secure. Engagement with patients, stakeholders and partners was effective.

We also found an area for improvement;

• The service did not meet the recommendations of the Intercollegiate Guidance on the levels of training required for staff involved in the care of children young persons under 18 years of age. 

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)

We spoke to one person who was using the service. They told us that they had signed a consent form and that the procedure had been explained by thier GP prior to being referred. They told us they were more than happy with the service and had attended their GP surgery only the day before and had received a telephone call the following day from the service with an appointment. One person told us “it is very impressive, the staff both on the telephone and in person are very good and have put me at ease." People told us and we observed that staff took the time to discuss the ultrasound scan and to ensure that they fully understood the findings of the scan. They told us they were more than happy with the service and had attended their GP surgery only the day before and had been rang the following day by the service with an apointment. " it is very impressive, the staff both on the telephone and in person are very good and have put me at ease." They told us and we observed that staff took the time to discuss the ultrasound scan and to ensure that they fully understood the findings of the scan.

Comments taken from the latest patient survey said" staff are friendly;" "staff are friendly and professional;"very friendly staff , explained everything to me , what was going on and what was to happen next;" "speedy and efficient service." Throughout the visit we saw that staff responded to people in a polite, professional manner.

We spoke to a patient who had been referred for an investigation and they told us that they had the procedure explained to them by the clinic staff, understood what they were told and gave consent for it to take place.

They told us that the service that they had received was very good and they were particularly complimentary about the manner in which they were welcomed and spoken to by the staff in the clinic. They said it was an anxious time and the way that they had been spoken to put them at their ease.