Archived: Alliance-Pioneer Group

Updated 30 April 2018

Mr Matthew Davey, who was also the registered manager, operates Alliance-Pioneer Group. The service started trading in 2002. It is an independent ambulance service providing events medical cover nationally, with the office based in Plymouth, Devon.

The service provides the following regulated activities:

1. Transport services, triage and medical advice provided remotely

2. Treatment of disease, disorder or injury

We previously inspected the service on the 24 August 2017, which was a comprehensive inspection and announced two weeks prior to our visit. We visited again during the unannounced period on 1 September 2017.

Updated 30 April 2018

Alliance Pioneer Groupis operated by Mr Matthew Davey. The main service provided by Alliance-Pioneer Group is events medical cover, which is outside the scope of regulation. However, they transport patients from event sites to local hospitals, which is in scope of our regulation. The provider was also providing patient transport services to transport patients between hospitals.

We carried out this focused follow-up inspection in response to a number of concerns which were identified at our previous comprehensive inspection in August 2017. We carried out our inspection on 6 and 8 February 2018.

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.

This inspection focused solely on the issues identified at our previous inspection where significant improvement was required.

The service had made some progress in addressing some of our concerns.

We found the following areas where the provider needed to make improvements:

• There was no evidence of robust incident investigation processes or any learning from incidents.
• Incidents, complaints and concerns were dealt with in the same policy and it was not clear if the service understood the difference between a concern and an incident.
• A training spread sheet had been introduced however some key evidence for safeguarding and resuscitation training was missing for some staff.
• Patient Group Directions (PGDs) and Medicines Administration Protocols (MAPs) needed further development, including appropriate authorisation before use.
• Two operational staff did not have evidence to show competence in emergency driving.
• Not all staff had provided evidence of DBS checks and one member of staff’s file did not contain this information.
• There was no evidence of any action planning following the staff risk survey or evidence of any other staff engagement.
• There was no evidence of any audit or scrutiny of recent care records at the time of the inspection.
• There was an outline audit schedule for 2018 but there was limited evidence of current audit and no evidence of any actions taken a result.
• There was no formal induction process or standardised induction programme for new staff joining the service.
• Not all policies had been updated and the infection prevention control policy was not service-specific.
• There was no system in place for the spot-checking of vehicles.
• There was no formal assessment of staff competencies, although some training and assessments were being planned.
• Terms of reference had not been established for the newly formed governance group and it was unclear how frequently the team were intending to meet.

However, we also found the following areas of good practice:

• There was a live spreadsheet for the recording and documenting of reported incidents.
• The provider had a comprehensive medicines policy that provided governance and guidance for staff.
• A medicines management training and competence package had been developed.
• Medicines and medical gases were ordered, stored, recorded and disposed of safely.
• Staff completed an infection prevention and control competence-based training booklet in the absence of training from their primary employer.
• Vehicle cleaning checklists had been modified to allow staff to record their initials against checks, but this had not been assessed yet to see if it was working.
• Managers had created a shared platform for key documents, but this was not yet accessible to remote staff.
• All permanent and contracted staff were to be offered appraisals, although this had not yet been implemented.
• The service held valid Disclosure and Barring Service (DBS) checks for most eligible staff and where cautions or convictions had been identified comprehensive risk assessments had been carried out.
• Professional registrations had been checked for all paramedics employed; however, no risk assessment was present for one paramedic with conditions against their registration.
• There was a new comprehensive risk register which contained details of current risks, reviews and actions and was to be reviewed as part of the new clinical governance group.
• Two senior managers had undertaken additional complaints training.

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 five requirement notices that affected urgent and emergency services. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (South), on behalf of the Chief Inspector of Hospitals

Updated 10 November 2017

Alliance-Pioneer Group provided medical events cover. This included a regulated activity when patients were transported from event sites to local hospitals for further care and treatment.

We found the provider was not assured of the quality and safety of the service it was providing and the competence of the staff they were employing. 

Updated 30 April 2018

Alliance-Pioneer Group provided medical events cover. This included a regulated activity when patients were transported from event sites to local hospitals for further care and treatment.

Since our last inspection where we found a number of concerns, we found the provider had made some improvements to the quality and safety of the service it was providing. The provider was better assured of the competence of the staff they were employing through improved recruitment and monitoring, however, there remained a lack of assurance that the provider held evidence to demonstrate all staff had undergone appropriate employment checks and mandatory training, relevant to their roles. The provider was yet to establish any induction programme for new starters, and we remained unassured incidents were effectively being captured and acted upon. We also saw very limited use of audits as a tool to drive improvements in the service, and audits and risk surveys which had been undertaken, did not demonstrate ay actions or changes as a result. Steps had been taken towards the safe management of medicines and medical gases, however Patient Group Directions had still not been properly authorised before use.