Southwest Veins Limited

Updated 21 November 2022

Southwest Veins Limited is the registered provider and is based at the Royal William Yard in Plymouth, which is the location for the management of the regulated activities. Southwest Veins provides Ultrasound Guided Foam Sclerotherapy (USGFS) for varicose veins and Microsclerotherapy for spider veins. Only USGFS is a regulated activity.

This is the first inspection of this service since registration in 2021. The service undertook 214 USGFS procedures and 357 ‘top up’ procedures from September 2021 to September 2022 for adults over the age of 18 years. The service was provided for patients mainly in the south west, but patients from other areas are welcome. Patients paid for their treatment as no NHS care is provided for varicose veins for cosmetic reasons. The premises comprise of a reception and waiting area, consultation room and treatment room in a Grade 1 listed building.

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

The provider is registered to provide the following regulated activity:

• diagnostic and screening procedures
• treatment of disease, disorder or injury.

The location had two registered managers in post since 2021 and 2022. Registered managers have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

The provider employs two permanent staff and eight members of staff on zero hours contract, on a sessional basis.

We inspected this service using our comprehensive inspection methodology. We carried out the short notice announced inspection on 12 October 2022.

Updated 21 November 2022

We had not inspected or rated this service before. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service usually controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Not all medicines were managed well.
• Staff provided good care and treatment and gave patients pain relief when they needed it. Managers did not always monitor the effectiveness of the service. Staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care and took account of patients’ individual needs, making it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services. Governance processes did not operate effectively throughout the service. There was not a systematic programme of clinical and internal audit to monitor quality, operational and financial processes, and systems to identify where action should be taken. The provider was not compliant with Schedule 3 regarding recruitment.

Updated 21 November 2022

We had not rated this service before. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• The provider did not seek assurance younger people seeking treatment were over the age of 18. The service did not perform hand hygiene audits. The service should store all medication in a locked cupboard. The provider immediately rectified this issue. The fridge temperature should be monitored daily while Glucagon was stored in there.
• The service should review its policies to ensure they are fit for purpose. This includes formulating a training policy and management of sepsis policy and reviewing the recruitment and incident reporting policies. The records relating to people employed did not all contain information relating to the requirements under Schedule 3. The provider does not have systematic programme of clinical and internal audit to monitor quality, operational and financial processes, and systems to identify where action should be taken.