The Care Quality Commission
  • Ambulance service

Archived: Medicar Limited (Clacton on sea)

Overall: Good read more about inspection ratings

14A Amerells Road, Little Clacton, Clacton On Sea, Essex, CO16 9HA (01255) 860453

Provided and run by:
Medicar Limited

All Inspections

4 October 2019

During a routine inspection

Medicar Limited (Clacton On Sea) is operated by Medicar Limited. The service provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the short announced inspection on 4 October 2019.

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 only service provided at this location was patient transport services.

This was the first time we have rated this service. We rated it as Good overall.

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and completed care records. The service had processes in place to manage safety incidents and had processes to learn lessons from them.

  • Staff provided good care and treatment and ensured patients had enough to drink. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. The service was available seven days a week.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. Feedback was continually positive about the way staff treated people. People told us that they thought staff went the extra mile. Staff provided emotional support to patients, families and carers.

  • The service planned care to meet the needs of people who were risk assessed as appropriate for the service, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with staff and local organisations to plan and manage services and all staff were committed to improving services continually.

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

  • We were not assured that staff followed the service’s policy on reporting safeguarding concerns.

  • Staff we spoke with were not aware of the service’s policy on accessing interpreting services.

  • We were not assured that quality monitoring of vehicle deep cleans and vehicle equipment took place.

  • We could not be assured that the risk register was reviewed regularly.

  • The service had key performance indicators (KPI) and was required to collect data, however the data was only collected for journeys provided under contract, instead of all journeys.

  • There was limited public engagement from the service.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

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

7 November 2016 and 21 November 2016

During a routine inspection

We carried out an announced inspection visit of Medicar Limited (Clacton on Sea) on 7 November 2016 and an unannounced inspection on 21 November 2016.

We were not committed to rating independent providers of ambulance services at the time of this inspection. However, we highlight good practice and issues that service providers need to improve.

We found the following areas of good practice:

  • Staffing was sufficient to meet patient need.

  • All staff were up-to-date with appraisals and mandatory training.

  • Staff had access to the information, support and supervision they needed to carry out their roles effectively.

  • Staff worked closely with each other and external providers to best meet the patient’s needs.

  • Staff were caring in their approach and had a highly patient-centred attitude, and patient feedback about the service was consistently positive.

  • Staff reported the working culture was positive and they felt engaged with the service.

  • The service was proud of the fact that a registered nurse escorted every patient during transfer.

  • The service was responsive to the concerns we raised and we found that much improvement had been made in relation to these concerns by the time of our unannounced inspection. For example, we raised safety concerns about the equipment, because the stretcher did not have all of the manufacturer’s recommended straps in place to secure patients during transport, and there were no handle grips or foot restraints on the carry chair. These had been addressed by the time of our unannounced inspection.

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

  • There was a lack of clear systems or procedures to ensure, if an incident occurred, that lessons would be learnt.

  • There was no risk register for the service. However, by the time of our unannounced inspection one had been developed, though this was not yet embedded.

  • There was a lack of formal or documented risk assessments for the vehicles and for patients being transported.

  • There was a lack of formal, clear record keeping. For example, daily vehicle checks, deep cleaning of vehicles, patient transfer forms, and driver competencies were not always well recorded.

  • There was no flagging system to clearly indicate if a patient was living with dementia or learning disabilities.

  • There was no system in place to indicate if a patient had been assessed as lacking capacity and how best to meet their needs.

  • The governance systems were not effective, which meant we were not assured that concerns issues would be identified and mitigated. The risks identified during our inspection had not been identified as issues by the management team.

Information on our key findings and action we have asked the provider to take are listed at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

13 February 2013

During a routine inspection

Due to the type of service we were unable to speak with people to get their views and experiences about the quality of the service they had received. The primary purpose of this service was transporting people to and from hospital.

We gathered evidence of people's experiences of the service by reviewing compliment cards received by Medicar Ltd. Comments included 'What a good service we've received from Medicar' and 'Thank you for the kindness shown to us.'

We found that the service assessed people's needs prior to transportation to ensure they could meet those needs and did not accept anyone who was not medically fit.

Records showed that the vehicles were maintained and fit for purpose.

The provider did not have effective systems in place to monitor and review the quality of the service provided. There were no staffing records available to review compliance in relation to recruitment of persons employed and their suitability for the role or how the provider supports persons employed.