Archived: Northampton Emergency Aid Team - Fernie Fields Scout Centre

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• The policies and guidance that were in place were outdated having been produced in 2013 and not reviewed.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