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Inspection carried out on 5 December 2017

During a routine inspection

Medevent Medical Services Limited is operated by Medevent Medical Services Limited. They are an independent medical transport provider based in Maidstone, Kent. The service provides medical cover at events such as music events, aviation events, and rugby matches for both adults and children. Trained paramedics, emergency care technicians, and ambulance care assistants are used to staff the services. The service has undertaken three emergency transfers in the last 12 months from events; it is these journeys that fall within the scope of registration with the CQC.

In England, the law makes event organisers responsible for ensuring safety at the event is maintained, which means that medical cover comes under the remit of the Health & Safety Executive (HSE). Therefore, the Care Quality Commission (CQC) does not regulate services providing ambulance support at events and this is not a regulated activity. The main service was event work, which the CQC does not regulate. Therefore, these services were not inspected.

The policies, procedures and expectations on staff including completing of patient report forms, administration of medicines, are the same for both the regulated activity and non-regulated activity. Therefore, we used these as evidence for this report.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 5 December 2017.

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.

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 issues that the service provider needs to improve:

  • There was an incident reporting system but a culture of incident reporting was not embedded in the service. Staff reported incidents verbally, but there was no formal recording of incidents or their severity, or how learning from incidents had been shared.

  • There were limited governance arrangements to monitor or evaluate the quality of the service and improve delivery.

  • The service did not have a business continuity plan. This meant the provider could not be assured that staff knew what to do in the event of an emergency, such as phone or radio system failure.

  • The service did not have a risk register, so they might not have identified, assessed, and mitigated key risks and issues.

  • The service did not have an effective system to ensure staff were up to date with competencies necessary to perform their jobs.

  • The service did not have an effective system to ensure staff were up to date with their mandatory training. Following the inspection the service sent us a structured mandatory training plan for all staff.

  • We found intravenous fluids stored on vehicles outside of recommended safe temperatures. The registered manager removed the fluids immediately from the vehicles and stored them in an appropriate location.

However, we found the following areas of good practice:

  • The registered manager demonstrated a dedication and motivation to improve the service. They spoke openly and honestly about the introduction of new systems and processes being implemented, or in their infancy and needing further development.

  • Patient report forms were fully completed and legible in line with guidance from the Joint Royal Colleges Ambulance Liaison Committee clinical practice guidelines. From review, we saw the service had adapted the patient report forms to include additional information, such an additional check for pain.

  • Staffing levels and skill mix was reviewed, planned and appropriate to ensure patients received safe care and treatment.

  • Emergency equipment was available, maintained, and serviced. Staff assessed and responded appropriately to potential risks to patients.

  • Medicines were well managed by the service. We saw there were effective systems to ensure medicines, including controlled drugs, were checked in and out at the beginning of an event.

  • The service was aware of national guidance relating to the provision of medical cover at an event. This was reflected in the services policies and procedures. However, we found some policies lacked some of the latest guidance and best practice references.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

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

Inspection carried out on 14 January 2014

During a routine inspection

Due to the nature of the service we were not able to talk with people who had used the service. This was because the service only provided care and treatment to people who required assistance at organised events.

People were supported to make informed choices and given the opportunity to agree to any care and treatment provided.

People’s needs were assessed before they were treated. This meant that people received care and treatment that ensured their health, safety and welfare.

A risk assessment and management plan was carried out for each individual event in order to ensure the service would meet the needs of the people who were attending these events.

Improvements had been made in the procedures for safeguarding people. In that there were now guidelines about how to manage any situations where staff identified someone may be at risk of abuse and there were improved monitoring systems to ensure staff had received appropriate checks.

The provider had procedures in place to ensure that staff were suitably qualified to meet the needs of the service.

There were suitable quality assurance processes in place that monitored the quality of the service.

Inspection carried out on 12 March 2013

During a routine inspection

Due to the nature of the service we were not able to talk with people who had used the service. This was because the service only provided care and treatment to people who required assistance at events such as concerts.

Events were planned so that appropriate numbers and skill mix of staff were available to meet the needs of the people who used the service.

Risk assessments were carried out for events and recommendations to improve safety were made and implemented.

We saw that people’s needs were assessed before they were treated and that treatment was planned and delivered in a way that ensured people’s health, safety and welfare.

We saw that there were appropriate arrangements in place to obtain, store, record and administer medication.

Although the registered provider was clear about how to safeguard the people who used the service, there was no policy or procedure in place. There was a lack of systems in place to ensure that the registered provider was satisfied that staff contracted to work for Medevents Medical Services Ltd had been subject to the appropriate checks.

There were suitable quality assurance processes in place that monitored the quality of the service.