Vista Diagnostics Limited operates as part of the InHealth group. The service provides MRI (Magnetic Resonance Imaging) diagnostic imaging facilities for children aged 14 and above and adults.

We inspected MRI diagnostic facilities only, using our comprehensive inspection methodology. We carried out an unannounced inspection on 15 November 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 service was MRI diagnostic imaging.

Services we rate

This was the first time we have rated this service. We rated it as requires Improvement overall.

We found areas of practice that require improvement in this service.

• Effective systems were not in place to keep people protected from avoidable harm.

• Infection prevention and control measures were not fully established. The environment in the scanning room was not visibly clean. There was no cleaning schedule or checklist for the scanning rooms. Staff were not always bare below the elbow, which was their policy.

• Stock control was poorly managed, and multiple items of out of date single use equipment were found.

• Medicines were not always stored in a locked cupboard, which was a risk to patients and the public.

• The oxygen cylinder from the resuscitation trolley was empty, which had not been identified by staff in the daily checks.

• The staff were not aware of the fringe field area around the MRI scanner which contact with could cause harm to some patients.

• The service was not safeguarding patients from the risk of falls by using wooden steps to get on to and off the scanning table. The wooden steps did not have a handrail.

• Processes were not sufficiently in place to ensure the correct patient received the correct scan on the correct area of the body.

• Staff did not always feel supported or listened to. The service did not always engage well with staff.

• There was not a positive culture that supported and valued staff. Staff morale was low.

However, we found good practice in this service

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

• Staff understood how to protect patients from avoidable harm, and the service worked well with other agencies to do so.

• The service had enough staff with the right qualifications, skills, training and experience to provide the right care and treatment.

• Information leaflets were provided in the service for patients on what the scan would entail and what was expected of them prior to a scan.

• Staff cared for patients with compassion. Staff provided emotional support to patients to minimise their distress. 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.

Following this inspection, we issued the service with a warning notice and told the provider that it must take some actions to comply with the regulations and that it should make other improvements. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London)

The clinic was undergoing a refurbishment following the installation of new equipment. We spoke with a number of people on the day of our inspection, who told us that they had been informed in advance of attendance about the refurbishment and of possible disruption and were not concerned. It had caused minor delays in consultation times but people told us that they had been offered alternative convenient appointments.

We saw that staff were courteous and professional at the reception area and people were addressed in a timely manner.

We saw the consulting rooms were private and lockable and that equipment was maintained and ready for use. These areas were visibly clean and the ambient noise was at a low level in spite of the building works. People told us that this had not affected their consultation.

There were private changing rooms with lockers available for personal belongings and a waiting area close to the diagnostics. People told us that this preserved their dignity in so far as they did not have to return to the general waiting area.

People told us that they were happy with the service and that they were well informed and knew what to expect from initial contact through to the collection of their results. This was confirmed on our review of the customer satisfaction survey.

People we spoke with who were using the service when we visited spoke positively about their experience.

One person said that the service had been quick and clean and friendly and the location was convenient and well served by public transport.