Kernow Ambulance Service

Updated 21 August 2018

Kernow Ambulance Service is operated by Kernow Ambulance Service. The service opened in 2014 as an independent provider transporting vulnerable adolescents and adults. The service is based in Bodmin, Cornwall and predominantly operates across the UK.

The registered manager, Lee Clarke, had been in post since 2014. He was the registered manager at the time of our inspection in October 2017.

The service is registered to provide the following regulated activities:

• Patient transport services, triage, and medical advice remotely.

During the short notice inspection on 13 June 2018, we visited the ambulance station and administrative office in Bodmin. We spoke with five staff including two Ambulance Healthcare Crew and three members of the management team. During our inspection, we reviewed 20 sets of patient records.

There were no special reviews or investigations of the service ongoing by the CQC at any time during the 12 months before this inspection. The service had previously been inspected once in October 2017. At that time, we found services did not achieve all the required standards of quality and safety it was inspected against.

Activity November 2017 to May 2018

• There were 532 patient transport journeys undertaken.

 25 Ambulance Healthcare Crew worked at the service.

Track record on safety:

• No never events
• 87 clinical incidents
• No serious injuries

The provider has not received any complaints.

Updated 21 August 2018

Kernow Ambulance Service is operated by Kernow Ambulance Service to provide a non-urgent patient transport service for patients with mental health conditions and learning disabilities. The service is operated from a base in Bodmin, Cornwall and provides transport across the UK for people aged between 14 and 65.

We first inspected Kernow Ambulance Service on the 24 October 2017. During that inspection we raised concerns about safety of service users. Following the inspection, we took enforcement action and issued a warning notice regarding the governance arrangements to monitor the service provision. We also issued two requirement notices. One was regarding the assessment and response to patient’s needs, with regard to the use of mechanical restraint in accordance with the Mental Health Act 2015, and the second related to pre-employment recruitment checks.

In January 2018, the registered manager sent us an action plan outlining the actions they had taken, and planned to take, to improve the areas of concern. We carried out a focused inspection on 13 June 2018 to ascertain if actions had been completed, and the concerns addressed. We announced the inspection at short notice to ensure the availability of key staff.

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:

• Incidents were fully investigated and the findings used to improve services.
• The named person for safeguarding was identified within policies for children and adults.
• Infection control procedures were safely managed including the risk from clinical waste, contaminated linen and the safe handling of sharps.
• Pre-employment processes were used to ensure only suitable staff were employed.
• All staff received mandatory and service specific training, records were kept up to date and compliance monitored to identify when update training was required.
• The risks associated with transporting patients with mental health needs were identified, assessed and used to inform care plans; including the potential need for restraint.
• Consent and mental capacity was assessed for each patient to ensure their rights were respected.
• The systems and processes introduced as part of governance arrangements provided an oversight of the quality and safety of the service provided to patients.
• The provider used audits and other assurance methods to improve the quality of services provided and maintain patient safety.

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

• Planning and recording for longer journeys where risks were increased due to comfort breaks and stops for ambulance driver rotations to occur.

Amanda Stanford

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

Updated 21 August 2018

Kernow Ambulance Service provides non-emergency ambulance transport, predominantly for people with mental health conditions. The provider also conducts transfers for patients detained under the Mental Health Act 1983.

During the inspection, we saw the provider had made significant improvements in response to the breaches identified within the warning notice and the two requirement notices. The senior management team could demonstrate a number of systems and processes which had been implemented to change practice and comply with the Health and Social Care Act 2008 (Regulated activities) 2014. This ensured a safer service to patients and effectively monitored the quality of services provided.