Archived: Pro Medicus

We carried out a focused unannounced inspection to review the service’s arrangements for the safe transport and treatment of patients following the suspension of their service. As this was a focused inspection, we did not inspect every key line of enquiry under the five key questions.

Are services safe at this service

Equipment was serviced and calibrated to ensure its safety and accuracy. A robust system for the storage of disposable items was in place with regular stock and expiration date checks. Mandatory training was carried out in line with the provider’s policy by all staff employed. Policies and procedures had been implemented to ensure staff were aware of responsibilities in relation to safeguarding. Information relating to local authority contact details were accessible to staff to ensure timely referrals if required. Medicines were stored appropriately and securely with only necessary staff being able to access them. Systems were in place to monitor the administration and disposal of medicines. Fire safety equipment was in place and staff were aware of the correct procedure in the event of a fire.

Are services effective at this service

Appraisal systems were now in place for all staff. An induction process and policy had been introduced to ensure new staff were aware of policies and procedures and possessed the required skills prior to beginning their role with patients.

Are services caring at this service

This was a focused inspection and we did not consider this as part of the inspection.

Are services responsive at this service

This was a focused inspection and we did not consider this as part of the inspection.

Are services well led at this service

A range of policies and procedures had been introduced by the provider to ensure safe working practices were in place. Staff were aware of these polices and where to locate them if needed. Governance arrangement to monitor and ensure quality had been introduced; sustainability relating to these was discussed with the management team.

Recruitment procedures were appropriate and staff files contained necessary information to ensure they were competent and suitable for their role and that all necessary pre-employment checks had been carried out.

The provider had made significant improvements to the service regarding governance processes, risk management, patient safety and the quality of care and treatment to be delivered.

Professor Sir Mike Richards

Chief Inspector of Hospitals

We carried out a focused unannounced inspection on 03 and 04 August 2015 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 five key questions.

Are services safe at this service

There were serious concerns that care and treatment was not being provided in a safe way for patients.

We found numerous items of equipment throughout the service that had not been serviced or calibrated to ensure its safe and accurate use. Disposable equipment items in both the store room and on vehicles were past their expiration dates.

Vehicles and equipment inside were not secure. We found that two vehicles were open and unlocked and that equipment, including defibrillators, oxygen cylinders and, airways equipment and first aid and dressing packs were all accessible and at risk of being tampered with.

There we inadequate processes in place for the management of medicines. We could not be assured that out of date medication had not been administered to patients, or that staff had recognised that medication was out of date. We asked staff to take immediate action regarding this.

Arrangements for safeguarding vulnerable adults and children were not adequate. There was a lack of safeguarding training to ensure staff were aware of their responsibilities. There was a risk therefore that staff would not be able to recognise and report potential safeguarding concerns.

There were no environmental and infection control audits to ensure the safety of patients and staff.

Staff had not had the required mandatory training including moving and handling, infection control, and administration of medicines.

Oxygen cylinders were not being stored safely. We asked staff to take immediate action regarding this.

Are services effective at this service

There were no systems in place to ensure staff were suitably appraised or received clinical supervision.

There was no evidence of an induction policy or process within the service.

Are services caring at this service

This was a responsive inspection and we did not consider this as part of the inspection.

Are services responsive at this service

This was a responsive inspection and we did not consider this as part of the inspection.

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 were minimal documented guidelines or policies for staff to follow. The management team had not taken sufficient measures to identify, assess and manage risks throughout all aspects of the service.

We found that the service did not have recruitment procedures in place to ensure that all staff were appointed following a robust check of their suitability and experience for the role, together with robust pre-employment checks having been carried out.

We identified poor practice where the provider needs to make improvements.

The service must take action to ensure:

• Robust governance and risk management systems are in place and understood by all staff.
• The service has effective and current policies in place that are understood by all staff.
• Recruitment processes are in place so all staff employed have the experience and competence required for their role, together with robust pre-employment checks having been carried out.
• Staff are supported in their roles by effective supervision and appraisal systems and ongoing training.
• Medicines are stored and administered to ensure there are no risks to patients.
• All equipment is fit for use and required checks and maintenance is carried out.
• Vehicles and premises security must be maintained.
• Robust safeguarding adults and children procedures are in place and understood by all staff.

Importantly, the provider must take action to ensure compliance with regulations 12, 13, 15, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (the Regulated Activities Regulations 2014). On this basis, the registered provider was subject to a Notice of Decision issued by CQC suspending its registration until 18 September 2015 and was not permitted to carry on any regulated activities until that time.

Professor Sir Mike Richards

Chief Inspector of Hospitals