New Malden Diagnostic Centre

Updated 25 July 2023

New Malden Diagnostic Centre is operated by Sterling Healthcare Group Ltd. The centre provides outpatient consultations, diagnostic imaging, minor surgery and treatment for all ages. The centre is located within an NHS GP practice.

Facilities at the centre include a diagnostic imaging unit, a treatment room and six consulting rooms. One of the consulting rooms is equipped with specialised Yttrium Aluminium Garnet (YAG) laser equipment for ophthalmology.

The centre offers a range of specialities including cardiology, neurology, dermatology, endocrinology, ENT, ophthalmology, orthopaedics and respiratory services.

The centre provides a range of diagnostic imaging services such as x-ray imaging, interventional and diagnostic ultrasound, electrocardiograms and magnetic resonance imaging (MRI). The service also has a service level agreement with a local NHS trust to carry out scans to help increase the trust's capacity.

The centre opened in 2010 and was managed by another provider until its sale and transfer to Sterling Healthcare Group in 2020. This is the first time we have inspected the service under Sterling Healthcare Group.

The provider is registered for the following regulated activities:

• Treatment of disease, disorder or injury

• Diagnostic and screening procedures

• Maternity and midwifery services

• Family planning

• Surgical procedures

Updated 25 July 2023

We had not previously rated this location under the current provider. We rated it as requires improvement because:

• The provider’s practising privileges policy did not set out what mandatory training was required by consultants.
• The service did not always manage infection risks well. There were no checklists to indicate when the patient toilets had last been cleaned and not all staff were bare below the below.
• Consultants held their own records which other staff could not access. The service was unable to demonstrate how they assessed and managed individual risks.
• The design, maintenance and use of facilities, premises and equipment did not always keep people safe. At the time of our inspection, not all electrical equipment had up to date safety tests.
• Staff did not use a recognised tool to identify deteriorating patients. Staff did not use the World Health Organisation safer surgery checklist when undertaking minor procedures.
• The service did not have a comprehensive programme of clinical audits to monitor the effectiveness of care and treatment.
• Leaders did not always operate effective governance processes. They did not use systems to manage performance effectively.

However:

• The service had enough staff to care for patients and keep them safe.
• Staff worked well together for the benefit of patients. Key services were available to suit patients' needs.
• 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.
• 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.

Updated 25 July 2023

We rated it as requires improvement because:

• Not all staff were up to date with all mandatory training including safeguarding and there was no safeguarding lead at the time of our inspection.
• The service did not have a comprehensive audit programme in place and systems for monitoring the effectiveness of the service.
• The provider’s practising privileges policy did not set out what mandatory training was required by consultants.
• Leaders did not run services using reliable information systems, such as having a comprehensive risk register.

However:

• The service had enough staff to care for children and young people and keep them safe. Staff provided good care and treatment. Key services were available six days a week and made sure staff were competent.
• Staff treated children and young people 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 children and young people, families and carers.
• The service planned care to meet the needs of local people, took account of children and young people’s 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.
• 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.

Updated 25 July 2023

We rated the service as requires improvement because:

• The doors to the MRI suite were not self-closing and locking with security locks that could be operated by MR authorised personnel only from the outside but freely opening from the inside in case of emergency.
• Not all equipment at the time our inspection had an up to date portable appliance test.
• Not all staff were up to date with all mandatory training including safeguarding and there was no safeguarding lead at the time of our inspection.
• The service was not able to evidence quality assurance programmes were in place for all modalities.
• The service did not have a comprehensive audit programme in place.
• The service did not use the World Health Organisation (WHO) surgical safety checklist for radiological interventions for invasive procedures such as ultrasound guided injections.
• We found a medicines cabinet in in the department which did not have a lock and contained medicines.
• The service did not manage infection risk well. The service stored patient gowns on top of locker cabinets where they could collect dust. There were no checklists to indicate when the patient toilets had last been cleaned and not all staff were bare below the below.
• There was a poster in the radiology department which had incorrect instructions and referred to a previous provider’s policy.
• The service did not have regular formal radiology team meetings that were minuted.

However:

• The service had enough staff to care for patients and keep them safe.
• Staff worked well together for the benefit of patients. Key services were available to suit patients' needs.
• 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.
• Staff generally 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.

Updated 25 July 2023

We had not previously rated outpatients at this service. We rated it as requires improvement because:

• The service did not always manage infection risks well. Hand hygiene audits were undertaken annually and not at regular intervals.
• Patient notes were limited to nursing records of minor procedures.
• The design, maintenance and use of facilities, premises and equipment did not always keep people safe. At the time of our inspection, the service was not up to date with equipment testing.
• The service did not have a comprehensive audit programme to monitor the effectiveness of care and treatment.
• Leaders did not demonstrate full understanding of the issues the service faced or how to manage them. They did not always operate effective governance processes. Leaders and teams did not use systems to manage performance effectively. They did not always manage risks effectively.

However:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills and understood how to protect patients from abuse. Staff worked well together for the benefit of patients. Key services were available to suit patients' needs.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, 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.
• Staff generally 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.

Updated 25 July 2023

We had not previously rated this service. We rated it as requires improvement:

• The providers practicing privileges policy did not set out what mandatory training was required by consultants.
• Staff did not use a recognised tool to identify deteriorating patient.
• Staff did not use World Health Organisation (WHO) safer surgery checklist in theatres, which was designed to prevent avoidable mistakes.
• Hand hygiene audits were undertaken annually.

However:

• 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. Staff kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment advised patients pain relief when they needed it. Staff worked well together for the benefit of patients. Key services were available six days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, they provided emotional support to patients.
• The service planned care to meet the needs of local people 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.
• 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 with and staff were committed to improving services continually.