Grange Farm

Updated 17 July 2023

We carried out an inspection of Grange Farm using our focussed methodology under the core service framework of Emergency and Urgent Care. The service had no plans to undertake and had suspended any Patient Transport Services activity following our inspection on 6 September 2022.

The inspection was a focussed inspection to follow up concerns from our inspection of the service on 29 November 2022 and 6 September 2022, when we imposed an urgent suspension on the registration of the service. CQC regulates the emergency and urgent care service provided by IKON. The other services provided by IKON, are not regulated by CQC as they do not fall into the CQC scope of regulation. The areas of IKON Limited that are not regulated are provision of first aid treatment onsite at events.

The service had appointed a new registered manager since our last inspection.

As this was a focussed inspection, we did not inspect all elements of the key questions. We reviewed elements of two of the five questions: are services safe and well led. We did not review the questions: are services caring, effective and responsive.

Grange Farm is operated by the registered provider IKON Ambulance Services Ltd. It is an independent ambulance service that supplies paramedics, emergency technicians, and first responders. The service provides first aid support at organised sporting and public events such as stock car racing, horse shows, and agricultural shows - this activity is out of scope of our regulations. As part of the events support, IKON Ambulance Services Ltd also provide medical transportation, including emergency transfers to local emergency departments, which is a service regulated by CQC.

The service is also registered to provide patient transfer service. However, this element had been suspended by the service.

Patient transport services is a small proportion of service's activity. The main service was urgent and emergency care. Where arrangements were the same, we have reported findings in the urgent and emergency care section.

The service is registered to carry out the following regulated activities:

• Transport, triage, and medical advice provided remotely

• Treatment of disease, disorder, or injury

The previous inspection of IKON ambulance service took place on 6 September 2022. We took this action because there was a high risk that a service user may be or will be harmed. We had serious concerns about urgent and emergency care and patient transport services. Following the inspection, IKON ambulance services Ltd. was served with an Urgent Section 31 notice of suspension of regulated activities for 12 weeks to allow the service to improve. An inspection on 29 November 2022 continued to identify concerns that could impact on patient safety within the service. On 1 December 2022 CQC issued a notice of proposal to cancel the service and also separately, to continue the suspension of the service until 2 June 2023. On 12 January 2023 the service submitted representations not to cancel the service. On 17 March 2023 we issued a notice of decision not to cancel the registration of the service. On 16 May 2023 CQC carried out an inspection of the registered location to see if the improvement had been made within the service and if action had been taken on risks that had been highlighted from previous inspections.

Updated 17 July 2023

Our rating of this location improved. We rated this service as requires improvement. As we did not rate against all the key lines of enquiry the service retains its inadequate rating for effective and requires improvement rating for responsive. This means the overall rating of the service is requires improvement.

On this inspection we found that:

• 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. They had set up systems to manage medicines.
• Leaders set up services using reliable information systems to monitor performance. Most staff understood the service’s vision and values. Staff felt respected, supported and valued and were clear about their roles and accountabilities. Staff were committed to continually improving services.

Updated 17 July 2023

The rating of this service has improved. We rated this service as requires improvement. As we did not rate against all the key lines of enquiry the service retains its inadequate rating for effective and requires improvement rating for responsive. This means the overall rating of the service is requires improvement.

• 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. They managed medicines well.
• Managers made sure staff were competent.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.
• All staff were committed to improving services continually.