The Care Quality Commission
  • Ambulance service

Archived: Mariner Medical Services Limited

Overall: Requires improvement read more about inspection ratings

64 Woad Lane, Great Coates, Grimsby, South Humberside, DN37 9ND 07796 264355

Provided and run by:
Mariner Medical Services Limited

All Inspections

10 December 2019

During a routine inspection

Mariner Medical Services Limited is operated by Mariner Medical Services Limited. The service provides emergency and urgent care and a patient transport service (PTS). The service was previously called Mariner Medical and Driving Services; the name was changed in 2017.

The service provides first aid and medical cover at local events, which is not regulated by CQC; however, the transport of patients from events is also provided and this does fall within the scope of CQC registration. Due to there being only one patient transfer from an event in the year prior to our inspection, the focus of this report will be the PTS aspect of the business.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 10 December 2019.

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?

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 by this service was patient transport. Where our findings on emergency and urgent care, for example management arrangements, also apply to other services, we do not repeat the information but cross-refer to the PTS section.

We have not previously rated this service. We rated it as Requires improvement overall.

  • The service did not maintain a consistent record of staff training and competence.

  • Risk assessments for patient transfers were not documented for either PTS or events’ journeys.

  • We found the service did not have polices in place relating to management of the deteriorating patient, information governance or medicines’ management.

  • We were not assured that managers and staff were familiar with policies.

  • The service did not have processes in place to monitor effectiveness.

  • Staff induction records were not retained, and appraisals were not documented.

  • There was no established process in place for people to give feedback or raise concerns and the service did not have a policy in place for the management of complaints.

  • The service did not have a documented vision or strategy.

  • We were not assured governance of the service was robust.

  • Pre-employment checks were not retained in staff records.

    However:

  • The service had enough staff to care for patients and keep them safe. Staff understood how to protect patients from abuse. The service controlled infection risk well.

  • Staff ensured patients’ comfort and worked well together for the benefit of patients.

  • Staff told us they treated patients with compassion and kindness, respected their privacy and dignity, and provided emotional support to patients, families and carers. Patients we spoke with confirmed this.

  • Leaders were approachable. Staff felt respected, supported and valued, and were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.

    Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements. We also issued the provider with four requirement notices that affected both core services. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North Region), on behalf of the Chief Inspector of Hospitals

17 November 2017

During a routine inspection

Mariner Medical and Driving Services Ltd is operated by Mariner Medical and Driving Services Ltd. The service provides mainly event cover, which is not a regulated activity and transport of patients from event sites which falls within our scope of registration.

We inspected this service using our comprehensive inspection methodology. We carried out the announced inspection on 17 November 2017.

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?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following issues during our announced inspection that the service provider needs to improve:

  • The provider was not always completing pre-employment checks as detailed in its recruitment policy. The provider did not have evidence of references, identity checks, professional registration, where appropriate, for paramedics and volunteers.
  • The provider did not have an effective system to ensure staff allocated to work had the necessary competence to undertake their role.
  • Not all staff had undergone an appraisal or a formal review of their performance.
  • Evidence of mandatory and external training completed by staff was not fully reflected in training records, so that training completion could not be fully assessed against best practice standards.
  • There was no clear process for incident reporting and using this learning to improve practice.
  • Standard care bundles were not in place for the transportation of patients.
  • The provider did not have an effective system for cascading and sharing any lesson learnt from complaints.
  • The provider had not developed a vision and strategy for the service. The provider did not formally engage all staff, to ensure that the views of all staff were noted and acted on. There was a lack of governance within the service. Some policies were absent or where present had not been reviewed and adapted for the service.
  • Service user records were not always managed effectively and patient report forms were not always stored securely.
  • The provider did not have a risk register and the provider was unable to demonstrate how risks were identified and escalated in order to protect patients. Audits such as infection control were not undertaken and therefore learning did not take place from review of procedures and practice.
  • The provider did not have an effective system in place to ensure all vehicles were well maintained and safe for use.

However; we found the following areas of good practice:

  • There was a positive culture within the service to learn and improve.
  • The service had recently implemented improved systematic processes such as deep cleaning checks on vehicles.
  • The provider had engaged with its partners and encourages them to provide positive or negative feedback.
  • Staff and managers we spoke with understood the duty of candour regulations and the requirement to be open and honest.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices details of which are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North Region), on behalf of the Chief Inspector of Hospitals