Archived: Cavendish Imaging Oxford

Updated 21 December 2018

Cavendish Imaging Oxford is operated by Cavendish Imaging Limited. The service is in Oxford and serves the surrounding communities within Oxfordshire. It also accepts patient referrals from outside this area.

The service is registered to provide the regulated activity diagnostic and screening and its registered manager has been in post since 2012.

The service specialised in providing cone beam computed tomography (CBCT) and offered panoramic (orthopantomogram, or OPG) dental X-rays of the lower face. It also offered cephalometric X-rays for side views of the face. Dental CBCT is a type of X-ray used to produce three dimensional images of teeth, soft tissues, nerve pathways and bone in a single scan. An orthopantomogram is an X-ray image of the whole mouth, including upper and lower jaw, produced when the X-ray machine moves around the head to provide an ear-to-ear image. A cephalogram is an X-ray of the skull and soft tissues, used to assess the relative position of teeth, jaws, skull and soft tissue.

Patients were referred by dentists, orthodontists and craniomaxillofacial surgeons. The service sent the resulting images to the referrers, however the provider could also offer a reporting service by a consultant radiologist, if this was required.

The service operated an appointment service, on average 4 days a month.

The Care Quality Commission (CQC) report from the last inspection, published in March 2013, showed Cavendish Imaging Oxford met the five standards inspected, taken from the essential standards as described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009. The five standards selected for inspection were: respect and involve, care and welfare, safeguarding, safety and suitability of equipment and assessing and monitoring the quality of service provision.

For this inspection, we announced our site visit at short notice (48 hours) on 21 September 2018, in line with our methodology for a service of this size. The service asked recent patients if they would consent for us to phone them after the visit, to speak with them about their experience of care. We carried out these phone calls during week commencing 1 October 2018.

Updated 21 December 2018

Cavendish Imaging Oxford is operated by Cavendish Imaging Limited. It provides a private scanning service for patients as part of planned dental work, often for dental implants. The service is on the ground floor and occupies a room within a building used by healthcare professionals. The service’s single, combined imaging unit is in a small room in the core of the building, with an adjacent administration area. There is a shared reception area and waiting room, also on the ground floor. There are no overnight beds.

The service provides imaging services for adults, young people and children. It is open approximately four days a month.

We inspected this service using our comprehensive inspection methodology. We carried out the short-notice announced inspection (48 hours) on 21 September 2018. The unit was not operational on the day of our visit, and after our site inspection we gained consent from recent patients to telephone and ask them about their care.

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 was diagnostic imaging.

Services we rate

We rated it as good overall.

• The provider established safe systems for delivering imaging services at this unit. For example, it recruited registered radiographers to deliver the imaging services, and checked their competencies and skills regularly through a systematic appraisal and training programme. Data was stored and transferred securely, using protected, electronic platforms.

• A key aim for the service was to provide a caring, patient-focused service, and the provider sought feedback from patients to help identify improvements. Patients said they were treated with kindness and staff were professional and courteous.

• Staff were aware of policies and procedures for delivering safe care, including those relating to safeguarding adults and children.

• The imaging equipment was maintained and safety tested and the Local Rules defined safe operating procedures.

• There was appointed and accessible safety staff; the radiation protection supervisor, radiation protection advisor and the medical physics expert. The radiographer at the Oxford service was the provider’s infection control lead, and was supported to develop this role. There was an audit programme that included image quality control assessments, health and safety and infection control audits.

• The provider’s policies and procedures were aligned to the Ionising Radiation (Medical Exposure) Regulations, to promote safe practices.

• There was clear leadership of the service and staff felt supported and able to raise concerns. Issues were reviewed for learning and to improve practices, and staff had regular meetings. These were used for staff to discuss areas for improvement, celebrate successes and learn about any company changes.

• The unit was located on the ground floor and accessible to people in wheelchairs and for those with a hearing impairment. Patients attended pre-booked appointments, and there was no waiting list.

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

• The provider should ensure that patients have access to the complaints process.
• The provider should ensure patients receive information in advance about what to expect.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

Updated 21 December 2018

We rated this service as good because it was safe, caring and responsive and well led. We do not rate effective in this type of service.

The service was operated by a radiographer from the provider’s main site in London, approximately 4 days a month