12 & 13 July 2016
During a routine inspection
Coperforma Demand Management Centre is an independent organisation, which manages patient transport service (PTS) for patients who meet the eligibility criteria within the areas of Hampshire, London and Sussex. Coperforma manages patient transport service between patient’s homes and hospital. The service does not have a fleet of vehicles, but operates by managing the required transport and subcontracts the transportation of patients to a number of transport service providers.
We undertook an unannounced comprehensive inspection of the Coperforma Demand Management Centre at Andover on 12 and 13 July 2016. We inspected against the following key questions: are services safe, effective, caring, responsive and well-led?
We do not currently rate independent ambulance providers; therefore, ratings were not applied.
Our key findings were as follows:
-
The service had a system in place for reporting and recording incidents. However, learning and action points from incidents and complaints were not disseminated to staff. Systems and processes were not always reliable and appropriate to keep patients safe.
-
Vehicles and equipment used by transport providers were not always safe and appropriate.
-
Comprehensive quality assurance checks had been performed on all transport providers, to ensure they met the necessary requirements in a number of areas.
-
Patient transport service was managed, in line with the current standards and legislation. Staff had the skills to carry out their roles effectively, and in line with best practice.
-
Some services were planned and delivered in a way that met the needs of local population. However, due to the patient transport not being reliable and timely some patients could not access services, for assessment, diagnosis or treatment when they needed to. The service had developed and introduced a number of initiatives to improve access.
-
The service did not have a robust system for handling, managing and monitoring complaints and concerns.
-
We observed patients were treated with respect and kindness during all interactions with staff. Staff explained the care and treatment they needed to provide appropriately for each patient so they understood. Patients received information in a way that they could understand.
-
Vision and strategy had not been developed. The service did not always proactively engage all staff, to ensure that the voices of all staff were heard and acted on. Performance issues were being reviewed, and joint work with other organisations had commenced to address these concerns.
-
The provider did not demonstrate they fully understood their legal requirements with regard to the Health and Social Care Act 2008. They had not assessed the two centres in Sussex against the Commission's "What is a location" criteria to identify whether they needed to follow the Commission's legal requirements to add the locations to the provider’s registration.
-
The service was looking for ways to develop, improve and sustain the service and had introduced a number of IT interventions improve care for patients.
There were areas of poor practice where the location needs to make improvements.
Importantly, the location must:
-
Ensure a robust system is in place for handling, managing and monitoring complaints and concerns.
-
Ensure robust systems are in place to assess, monitor and improve the quality and safety of the services provided.
-
Ensure the vehicles and equipment used by contracted services is appropriate for safe transportationof patients, including wheelchair users
-
Ensure patients receive timely transport services so they can access the health services they need from other providers.
-
Ensure there is learning from incidents and the learning and changes to practice are shared across all staff.
-
Ensure transport provider staff always have essential information about patient’s needs so care is delivered safely and risks to patients are minimised.
-
Ensure systems and processes are in place to implement the statutory obligations of Duty of Candour.
-
Ensure a vision and strategy for the service developed and to ensure this is embedded across the organisation.
-
Ensure a manager for the regulated activity is registered with the Commission.
-
Ensure the provider and registered persons understand their legal requirements with regard to the Health and Social Care Act 2008. This must include a review of all centres against the Commission's "what is a location" criteria and where necessary follow the Commission's legal requirements to add the locations to the provider's registration.
-
Ensure the Commission is notified of safeguarding incidents and incidents affecting the running of the service.
In addition the location should:
-
To proactively engage and involve all staff to ensure voices are heard and acted on.
-
To ensure a system is place to monitor and review staff training needs.
-
Ensure all staff are trained in Duty of Candour.
-
Continue to develop and embed the service delivery specialist role in the local hospitals.
-
Ensure the ‘Simultaneous Translation Service’ or any similar system is implemented so translation services are always available.