• Hospital
  • Independent hospital

InHealth Endoscopy Unit Romford

Overall: Good read more about inspection ratings

Lambourne House, 2nd Floor, 7 Western Road, Romford, Essex, RM1 3LD (01494) 560000

Provided and run by:
InHealth Endoscopy Limited

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about InHealth Endoscopy Unit Romford on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about InHealth Endoscopy Unit Romford, you can give feedback on this service.

25 October 2021

During a routine inspection

Our rating of this location stayed the same. 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. They managed medicines well. The service managed safety incidents well and learnt lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care to patients and monitored their pain. 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.
  • 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 people who use the service, 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 an endoscopic procedure.
  • 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 managed services and all staff were committed to improving services continually.

However:

  • The service did not have protocols and care bundles for identifying potential sepsis and staff did not have training in this. This was identified at the previous inspection and it had not been rectified.

4 January 2019

During a routine inspection

InHealth Endoscopy Unit Romford is operated by InHealth Endoscopy Limited as part of a network of locations within a specialist services directorate. The service is a community clinic and provides care and treatment to patients who are medically fit and stable.

The clinic has two preparation (admission) rooms, one consultation room, two procedure rooms, four single recovery bays and a seated discharge area with two reclining chairs. The service is commissioned by Barking, Havering and Redbridge Clinical Commissioning Group to provide colonoscopy, flexible sigmoidoscopy and gastroscopy for routine referrals. The service is co-located with a pathology service and breast screening service, which are operated by separate providers in the organisation’s group. Each service has its own registration and we did not inspect the pathology or breast screening services. The clinic has in-house endoscope decontamination facility and trained staff.

The service provides care and treatment to patients referred by the NHS to reduce waiting times.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 4 January 2019.

The service had typically operated four days per week from 8am to 6pm and at the time of our inspection had started to work towards seven-day working. The service had clinical space to accommodate this and the senior team were building staff numbers to ensure expansion was carried out safely.

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 have not previously rated this service. We rated it as Good overall.

We found good practice:

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
  • Processes for safe water management were robust and ensured patient’s safety. Staff had taken immediate action where routine testing indicated a risk.
  • The service team acted on audits and quality evaluations to continually identify opportunities for benchmarking and improvement.
  • Safety and risk management processes were clearly embedded in practice and a strict referral system meant staff saw patients only when they had enough information to provide a safe level of care.
  • Staff managed all areas relating to health and safety, such as medicines management and staffing, in line with established processes and protocols. The unit manager ensured protocols were reviewed and updated in a timely fashion to reflect the latest national standards.
  • The provider facilitated a no-blame culture that encouraged open discussion of mistakes and reporting of incidents. This included use of the duty of candour, which staff used to ensure patients were kept informed when things went wrong.
  • The service had a waiting list and managed this well. In the previous 12 months the service had met the standard six-week referral to treatment time (RTT) in 11 months.
  • Governance processes included all staff and helped the team to assess the quality of the service and to drive development and improvement. The governance structure was being expanded and improved as part of a five-year development plan.

We found areas of outstanding practice:

  • The provider was an early adopter of transnasal gastroscopy services, which provided a more comfortable experience for patients and reduced the need for sedation.

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

  • Two members of staff had significant lapses in safeguarding training that required action.
  • Although overall standards of infection control were good, there were risks in relation to how staff used the decontamination area and discrepancies between service standards and audit criteria.
  • There were some discrepancies between the understanding of the local team in relation to incidents and complaints and the data submitted to us by the provider. Although investigations and learning outcomes were clearly documented, the discrepancies meant there was a lack of assurance they led to embedded new practice.
  • There were gaps in the arrangements for risk management, including in the risk assessments used for patients and in environmental maintenance and safety.
  • In the previous 12 months the service had cancelled seven patient lists due to a shortage of endoscopists.
  • Gaps in documentation for staff competencies and feedback from the staff survey indicated inconsistent supervision practices.

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

  • Implement consistent standards of practice in relation to the safe management of Controlled Drugs (CDs). This should include effective audit processes.
  • Provide staff with the tools to monitor patients for deterioration and to respond to urgent clinical needs.
  • Implement robust, consistent safety and maintenance processes for emergency equipment.
  • Minimise infection control risks through effective, consistent audits and practice.
  • Review safety monitoring and training to manage risks associated with major haemorrhages and sepsis.
  • Store sufficient quantities of oxygen stored on site to meet patient need, including during unplanned emergencies.
  • Actively embed learning from incidents and other safety issues elsewhere in the organisation.
  • Require all staff, including agency staff, to fully complete induction and orientation processes and document this. 
  • Improve local governance systems and administration to include the quality of complaints reponses and staff induction documentation.

Professor Sir Mike Richards

Chief Inspector of Hospitals