Archived: Air Med Transport Limited

Updated 6 May 2020

Air Med Transport Limited is operated by Air Med transport Limited. The service has been registered to provide a regulated service since March 2016.

The provider is an independent ambulance service that is based in Perry Barr in Birmingham.

The service mainly provides secure transport for patients with mental health needs and transport for patients discharged home from hospital.

Patients transported by the service are physically well which means vehicles were not equipped in the same way conventional ambulances might be. The vehicles are not adapted for patients with physical conditions and therefore did not have emergency equipment or drugs on board.

The service had a registered manager in place since registration in March 2016.

The service is registered to provide the following regulated activity:

• Transport services, triage and medical advice provided remotely.

During the inspection, we visited the provider’s base unit, which is where the service was provided from. There were no other registered locations. We inspected two of the service’s vehicles.

We spoke with the registered manager, the administrator and two transport staff.

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 was previously inspected on 27 November 2019. The service was rated as inadequate. We suspended the service on 29 November 2019, following the inspection, and the suspension end date was 24 January 2020.

The provider had 13 areas for improvement:

• The provider must ensure required training is provided through an accredited training provider.
• The provider must ensure staff using handcuffs are adequately trained.
• The provider must ensure that the safeguarding lead is trained to level 3 and have sufficient knowledge and qualifications to cascade safeguarding training to their staff.
• The provider must ensure that all staff have documented Disclosure and Barring Service (DBS) checks.
• The provider must ensure premises, vehicles and equipment are clean to protect patients, staff and others from infection.
• The provider must ensure vehicles and equipment are maintained to protect people from avoidable harm.
• The provider must ensure there are appropriate procedures were in place to assess and respond to patient risk.
• The provider must ensure there are policies for staff to follow that are in line with current guidance. These should include the use of high-level restraint.
• The provider must ensure the service identifies, records and manages risks.
• The provider must ensure the service has a systematic approach to oversight and maintenance of effective policies and procedures.
• The provider must ensure the service has a systematic approach to checks of cleanliness and infection prevention and control.
• The provider must ensure there is a systematic approach to checks of vehicle and equipment maintenance.
• The provider must ensure there is sufficient management of training to ensure staff received accredited and appropriate training for their roles.

The service employed nine staff. This consisted of a part time administrator, a part time cleaner, drivers and escorts. Two drivers were employed full time and the rest were employed on a zero-hours contract basis, whereby staff were allocated shifts to be ‘on-call’ throughout the week. Should a transfer be requested, on-call staff would be contacted and asked to attend work.

The service had a fleet of six vehicles including unmarked cars, an ambulance and minibuses.

There were no enquiries of concern made to CQC since we inspected the service in May 2017.

The provider had given a provider return in June 2019. The provider was asked if they wanted to provide more up to date information for the inspection but asked us to use the existing information.

Due to the ongoing suspension, the service was not operational at the time of this inspection. The service had only completed one mental health patient transfer in November 2019 before the suspension started.

.

Updated 6 May 2020

Air Med Transport Limited is operated by Air Med transport Limited. The service provides a patient transport service.

We inspected this service using our focused inspection methodology. We reviewed two of the five questions, are they safe and well-led? We did not review the questions, are they caring, effective and responsive to people's needs.This inspection was to follow up concerns from our inspection of the service on 27 November 2019, when we suspended the service.

The service provided patient transport, including transporting persons detained under the Mental Health Act 1983.

We rated this service as Inadequate overall.

We found the following issues the service provider needs to improve:

• The service did not always provide mandatory training in key skills to staff. Driver training was not always provided by an accredited provider. Staff had not received training in the use of hard handcuffs, patient moving and handling and other mandatory training such as infection prevention and control. Staff had completed safeguarding training, but this was not level two safeguarding training.
• Staff Disclosure and Barring Service (DBS) checks were in progress but not completed.
• Staff records did not always include pre-employment checks; such as an application form or references.
• The service did not always control infection risk well. Staff did not always keep vehicles visibly clean.
• The lack of maintenance of vehicles and equipment put people at risk of avoidable harm.
• Processes to assess and respond to patient risk were unsafe.
• Policies available to staff were not always in line with best practice guidelines or reviewed regularly.
• The service did not keep individual care records for patients. Staff did not always complete records accurately.
• The provider did not appropriately manage patient safety incidents. The provider did not investigate incidents or share lessons learned with the whole team.

We found there had been some improvements since the last inspection on 27 November 2019:

• The provider had created an action plan to address staff mandatory training. This was still in progress at the time of the inspection. Staff had completed some mandatory training provided by an external company.
• The registered manager, who was safeguarding lead, had completed safeguarding level three training.
• The vehicle storage and cleaning areas were clean and tidy.
• The provider had booked a visit from an engineer to check the service’s equipment the week after the inspection.
• An ambulance was at a garage and some repairs of the vehicle had been carried out, including re-covering of seats and making sure there were no leaks in the external structure.
• The provider had developed an action plan to make the improvements needed. However, most of the actions were still not started or in the initial stages at the time of the inspection.

Following this inspection, we extended the suspension of this service until the provider could demonstrate that it had improved.

This service will continue to be in special measures.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Heidi Smoult

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals

Updated 6 May 2020

The service provided patient transport, including transporting persons detained under the Mental Health Act 1983.

Vehicles and equipment posed a risk to patients and staff. There was a lack of risk assessment for safely transporting patients. Staff who were driving patient transport vehicles had not received appropriate training. Policies and guidance were not fit for purpose. Staff Disclosure and Barring Service (DBS) checks were still in progress and not in place. Staff records were missing application forms and references. The service was not well led as there was a lack of clinical and operational oversight.