Archived: Northampton Emergency Aid Team - Fernie Fields Scout Centre

Updated 23 December 2016

Northamptonshire Emergency Aid Team - Fernie Fields Scout Centre (NEAT) was established in 1979 and provides patient transport services. They also supply first aid services to public events.

The aim is provide trained volunteer support to emergency services. Volunteer scouts and team leaders are trained to offer support in major incidents. The service developed and gained experience working alongside the local police and fire and rescue teams, offering support to major incidents within the local area, such as flooding.

NEAT consists mainly of scouts who have an interest in first aid and providing support to emergency services in the event of a major incident. The service does not provide direct emergency response services.

The service is registered for the regulated activity of transport services, triage and medical advice provided remotely.

At the time of our inspection, there was no registered manager in post.

We inspected the service on the 25 August 2016 and 3 November 2016. During the inspection, we saw one vehicle used and the main offices used by the service. The remaining vehicles were not available. We spoke with three members of staff.

Updated 23 December 2016

We carried out a focused unannounced inspection on 22 August and 31 October 2016 to review the service’s arrangements for the safe transport and treatment of patients as we received information of concern about this service. As this was a focused inspection, we did not inspect every key line of enquiry under the four key questions we inspected (safe, effective, responsive and well led). We did not inspect the caring key question.

Are services safe at this service

• There were robust systems in place to maintain the safety of volunteers less than 18 years of age.
• There were concerns that care and treatment was not being provided in a safe way for patients.
• There was no process in place for the safe management of medication, with staff providing their own medicines to administer to patients.
• Medical gases were not always secure and were at risk of tampering.
• There was no maintenance programme in place for equipment used, with gaps of several years between servicing.
• There was no evidence of regular audits to confirm compliance with infection control policies, and those that were completed had no actions associated with findings.
• Patients’ records were not always stored securely, with instances where records containing personal identifiable information had been left on vehicles for several days.
• The service did not provide the NHS recommended level of safeguarding children training for staff treating patients less than 18 years of age.

Are services effective at this service

• The service did not measure any patient outcomes, or benchmark its service against any other providers.
• Mental capacity act training was not provided.
• The policies and guidance that were in place were outdated having been produced in 2013 and not reviewed.
• The service provided clear guidance on what levels of training were expected for each role, and offered staff the opportunity to develop.
• The service provided supervisors and mentors for all staff.

Are services caring at this service

• This was a focused inspection and we did not gather evidence for this key question.

Are services responsive at this service

• The service did not provide services for those patients who were partially sighted; hard of hearing, wheelchair user or those for whom English was not their first language.
• Although the service received few complaints, there was no evidence of shared learning. There was not a robust system in place to act upon complaints.
• The service planned to meet the needs of local people, and provided a service based on an external risk assessment.

Are services well led at this service

• We found serious concerns regarding the governance and risk management processes of the service. There were no effective governance arrangements in place to evaluate the quality of the service and improve delivery.
• There was no nominated individual and registered manager within the service. This meant there was no one in place to take regulatory responsibility for the health services being provided.
• There were significant concerns about the way the service was managed and found breaches of regulations 7, 11, 12, 13, 15, 16, 17 and 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During the course of the inspection, senior managers confirmed that the service was no longer to provide the regulated activity of transport, triage and medical advice provided remotely and that the service was therefore planning to deregister,

The service must take action to:

• Ensure that a CQC registered manager and responsible person is in place.
• Ensure that the service has a strategy and updated statement of purpose.
• Ensure that staff have relevant safeguarding children level 3 training.
• Implement a system for monitoring compliance to policy.
• Implement a system to monitor patient outcomes.
• Implement a system to review service performance and benchmark against other organisations.
• Implement a risk register, which accurately reflects the service’s risks.
• Ensure that patient feedback is collected, analysed and used to improve services.
• Ensure that there are robust systems in place to communicate and evidence learning from incidents and complaints across the team.
• Implement a process for the safe management of medications, which should include the purchasing, storage and administration.

Importantly, the provider must take action to ensure compliance with regulations 7, 11, 12, 13, 15, 16, 17, and 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. When we immediately raised these concerns during the course of the inspection, senior managers of the Northampton scouts’ association confirmed that the service was no longer to provide the regulated activity of transport, triage and medical advice provided remotely and that the service was therefore planning to deregister.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 23 December 2016

We have not rated the patient transport service for the four key questions we inspected (namely safe, effective, responsive and well-led). This was a focused inspection and elements of this key question were not inspected. We did not inspect the caring key question. We found that:

• There were significant concerns about the way the service was managed and found breaches of regulations 7, 11, 12, 13, 15, 16, 17 and 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During the course of the inspection, senior managers confirmed that the service was no longer to provide the regulated activity of transport, triage and medical advice provided remotely and that the service was therefore planning to deregister.
• There were robust systems in place to maintain the safety of volunteers less than 18 years of age.
• The service did not have robust systems in place to maintain patient safety. This included poor management of medications and medical gases, lack of maintenance regimes for vehicles and equipment used, and poor management of patient records.
• The service did not provide staff with the recommended level 2 or 3 safeguarding children training.
• The service did not have audits in place to identify risks and maintained no risk register. There was no evidence of actions to be taken as a result of audit findings.
• The service did not formally record action taken in response to concerns or complaints raised. There was no evidence of information shared across the team, either as part of team development or in response to any learning.
• There was no system in place to capture patient outcomes, or benchmark the service against other providers.
• The service did not complete their own risk assessments for events, and were dependent on those provided by the event’s organiser. This meant that service did not always consider patients with partial sight, hard of hearing, wheelchair user or patients who did not speak English as their first language.
• Although the service received few complaints, there appeared to be no system in place for the investigation of complaints and the sharing of lessons learnt.
• The service did not have a registered manager in post for more 12 months.
• The service had no strategy or vision in place. There were no systems in place to monitor performance, risks or concerns.
• The service provided a clear structure for learning and developing staff, with tiers of learning dependant on staff roles. The service offered development opportunities and supported team members to achieve.