03 October 2017
During an inspection looking at part of the service
CasCare Limited (also known as CasCare Medical Services) is operated by CasCare Limited. The service provides emergency and urgent care.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 03 October 2017 along with an unannounced visit to the hospital on 19 October 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.
However, we also found the following issues during our announced inspection that the service provider needs to improve:
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We found concerns regarding a lack of formal recruitment process for all paramedic staff and volunteers, which included checking references, curriculum vitaes, photo ID, DBS and regular driving license checks.
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We were concerned about the lack of evidence of safeguarding training for all staff and volunteers. The safeguarding policy we reviewed on site did not reflect safeguarding children best practice and referral routes in cases of concern.
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We were concerned that the lead for safeguarding was not trained to the appropriate level for their role.
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We found there was not a peadiatric restraint on the ambulance in order to secure children when transporting them from an event.
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There was no formal process to deep clean the ambulance and there were no single use mop heads for the cleaning of patient areas.
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We were concerned that there was no formal process of reviewing policies, and there were no standard policies for treating patients during transport from event sites.Additionally we were concerned that not all staff and volunteers had signed to acknowledge they had read and understood the policies in place.
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There was no formal process to ensure all staff had the compentance to undertake all aspects of their role.
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We were concerned that volunteers were not trained using an externally verified training course. Additionally there was no formal staff appraisal which would ensure compliance with the expectations of the role and development
During our unannounced inspection we found progress had been made to address some of our concerns. These include:
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A formal recruitment process which included checking references, curriculum vitaes, photo ID, DBS and regular driving license checks.
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Training was being sourced for safeguarding training. The lead had changed and the policy had been reviewed to reflect the Intercollegiate Document 2014
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A paediatric restraint had been purchased and staff trained in how to use it.
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Enquiries had been made with regard to deep cleaning the vehicle.
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Policies had been reviewed, care bundles were being developed.
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There was a volunteer agreement in place which identified the roles and responsibilities of the volunteers.
We found the following areas of good practice:
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We recognise the additional pressures an inspection places on an organisation. All staff and volunteers were welcoming and professional with the inspection team. There was a sense that staff were open and honest with us.
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The risk assessment processes in place for service delivery at events were complete and robust.
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There was a widespread view that the organisation provided a beneficial service to the local community.
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There was practical training for volunteers to experience caring for patients in a moving vehicle.
Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices that affected urgent and emergency care. Details are at the end of the report.