Archived: Medicar European

Medicar European is an independent provider based in Ashford, Kent. The service provides patient transport and a repatriation service. The service employed trained paramedics, ambulance technicians and ambulance care assistants.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 28 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 areas of good practice:

• The service had an internal incident reporting process. There was a system to ensure all incidents were recorded and monitored, with learning and outcomes shared with staff.
• Vehicles had appropriate safety checks, were maintained and checked daily.
• Equipment was available and appropriately serviced and maintained.
• Staff understood their responsibilities to protect patients from avoidable harm. Staff knew about safeguarding and what constituted abuse.
• Policies and procedures were in place for cleaning and deep cleaning ambulances. Ambulances were visibly clean and staff followed infection control procedures including being bare below the elbow and using personal protective equipment.
• Patient records were held securely and included appropriate information.
• Staffing levels were sufficient to meet patient needs.
• Staff were confident in assessing and managing specific patient risks, and processes were in place for the management of a deteriorating patient.
• Staff could plan appropriately for patient journeys using the information provided by the booking system.
• Disclosure and barring service (DBS) checks were complete and meant the service were fully assured patients were protected from receiving care and treatment from unsuitable staff.
• Staff were trained in mental capacity and showed awareness of consent issues.
• Staff helped patients feel comfortable and safe. Staff responded with compassion when patients needed additional help or support.
• Patients and their relatives/carers received emotional and practical support from ambulance crews. Staff respected the needs of patients, promoted their well-being and respected their individual needs.
• Staff respected patient’s dignity, independence and privacy.
• Staff we spoke with were committed and passionate about their roles. They provided excellent care.
• The service used its vehicles and resources effectively to meet patients’ needs. Specially adapted ambulances were available to accommodate bariatric patients.
• Staff knew about the complaints and compliments system, and provided patients with information on how to make a complaint or extend a compliment.
• The service had a process in place to respond to feedback from patients and members of the public.
• The staff we spoke with enjoyed working for the service. There was an open culture and staff were focused on providing person-centred care.
• Staff felt supported by the managers of the service and said the managers were competent, approachable and accessible should they require any advice.

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

• A combined safeguarding policy for children and young people, and adults at risk had not fully reflected the differences for each group clearly.
• A few staff had no up-to-date safeguarding children training.
• No policies and guidance stated a review date.
• There was no evidence to show staff had read policies and guidance related to their roles.
• There was no documentation of key decisions at director and senior manager meetings, staff briefings and external stakeholder meetings.

Information on our key findings and actions we have asked the provider to take is listed at the end of the report.

Catherine Campbell

Head of Hospital Inspections (South East)