Archived: Medical Services Ltd (Luton)

Updated 27 March 2017

Medical Services Ltd (Luton) is an independent ambulance service providing patient transport and emergency ambulance services to NHS trusts across central England. Medical Services Ltd (Luton) is one of nine Medical Services Ltd locations and provides services across Hertfordshire, Bedfordshire and surrounding areas.

The service is registered for the regulated activities of:

• transport services, triage and medical advice provided remotely,

• treatment of disease, disorder or injury, and

• diagnostic and screening services.

We inspected, but have not rated, elements of four of the five key questions including safety, effectiveness, responsiveness and well-led.

The service had not had a registered manager in post since July 2015. At the time of the inspection, there had not been an application to register a new manager or notification to us of the absence of a registered manager.

Updated 27 March 2017

Medical Services Ltd (Luton) is operated by Medical Services Ltd. This independent ambulance service provides emergency and urgent care and a patient transport service.

We carried out this unannounced inspection on 16 January 2017 because we had received information of concern about the service. We did not inspect all elements of each key question, as this was a focused inspection.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided was patient transport services. Where our findings on Medical Services Ltd (Luton) – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the core service.

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:

• Effective standards of cleanliness and hygiene were maintained within the service.

• Generally, there were appropriate systems in place regarding the safe handling of medicines.

• All staff we spoke with understood their responsibilities to raise, record and report safeguarding concerns.

• The service had sufficient staff, of an appropriate skill mix, to enable the effective delivery of safe care and treatment on the days of our inspection.

• Appropriate arrangements were in place for the recruitment of staff and the service had a suitable policy in place.

• There was a formal process in place for gathering information and recording details relating to a patient’s medical condition when bookings were made.

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

• Staff understood their responsibilities to report incidents although they were not always given feedback so learning could be embedded in the service.

• Duty of candour processes had not always been followed.

• Generally, the service had systems in place to ensure the safety and maintenance of equipment; however, these were not always followed.

• At the time of our inspection, there was no registered manager (RM) in place for the service. There had not been an RM in place since July 2015.

• Effective systems were not in place to assess, monitor and improve the safety and quality of the care and treatment provided.

• There was a lack of effective processes to ensure learning from all incidents was disseminated throughout the service and to all staff.

• There was not an effective system in place to respond to complaints about the service.

• There was not a full understanding of all the risks in the service underpinned by effective systems to assess, mitigate, and monitor ensuing actions to reduce the risk of avoidable harm for patients.

• Risks found on inspection had not been recognised by the service.

• Storage facilities for controlled drugs did not meet safety standards.

Following this inspection, we told the provider that it must take some actions to comply with the regulations. We also issued the provider with two requirement notices that affected the patient transport service. Details are at the end of the report.

Edward Baker

Deputy Chief Inspector of Hospitals (Central Region)

Updated 27 March 2017

The lack of a registered manager had not been actioned by the provider for over a year. There were ineffective governance systems in place at the service to fully understand all risks the service and to ensure learning from all incidents and complaints was used to drive improvements in the service. Storage of controlled drugs was not appropriate. Duty of candour requirements had not always been followed.

Staffing levels, staff competency, safeguarding awareness and infection control procedures were satisfactory.

The service had sufficient staff, of an appropriate skill mix, to enable the effective delivery of safe care and treatment on the days of our inspection. Appropriate arrangements were in place for the recruitment of staff and the service had a suitable policy in place. There was a formal process in place for gathering information and recording details relating to a patient’s medical condition when bookings were made.