Archived: Buxton

Updated 19 November 2020

Buxton is operated by Peak Medicare Limited. The service opened in October 2011. It is an independent ambulance service in Buxton, Derbyshire.

The service has had a registered manager in post since December 2011.

Peak Medicare Ltd operates an independent ambulance service in North Derbyshire providing first aid and emergency responses at motorsport events in the north west of England. Additionally, it provides a first aid and emergency response service at community and national events held in the north Derbyshire area and wider afield.

Updated 19 November 2020

Buxton is operated by Peak Medicare Limited. The service provides emergency and urgent care mainly at event services. However, CQC does not have the power to regulate events. On occasions, the service treats and conveys patients to local NHS hospitals from events such as motorcycle speedway – this falls under the scope of registration.

The service was last inspected on 8 October 2019 and 5 November 2019. Regulatory non-compliance was found in respect of regulations 5, 12, 13, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. We served warning notices in respect of regulations 17 and 19 and requirement notices in respect of regulations 5, 12, 13 and 18. The service was rated inadequate overall and placed into special measures.

We carried out a remote assessment on 14 June 2020, which resulted in a Notice of Proposal to cancel the service’s registration, in respect of the following regulated activities:

• Transport services, triage and medical advice provided remotely.
• Treatment of disease, disorder or injury.

We also served a Notice of Proposal to cancel the service’s registered manager in respect of those regulated activities.

We decided to serve this notice of proposal, rather than take urgent action at that time as the service informed us they were not carrying on any regulated activities. This was due to government restrictions stopping all events as a result of the ongoing COVID-19 pandemic.

The service submitted written representations against the notices of proposal to cancel their registration and the manager’s registration. However, these were not upheld and therefore two Notice of Decisions to cancel the registrations, were issued on 22 September 2020 and 8 October 2020 respectively.

We carried out a short notice announced focused inspection on 6 October 2020, in response to concerns that Buxton had recommenced providing medical cover for events, and potential provision of regulatory activity taking place.

Our focused inspection concentrated on the aspects of the key questions of safe, effective and well-led. We spoke with the registered manager, company director and an external consultant (commissioned by the service to assist with compliance). As a result of this inspection we took further urgent enforcement on 9 October 2020, to suspend the provider’s registration to prevent regulated activities from being carried out.

The main service provided by this service was urgent and emergency care.

We inspected this service using our focused inspection methodology. We did not update previous ratings of this service.

Our main findings were:

• The service did not provide mandatory training in key skills, including the highest level of life support training, to all staff. They did not make sure everyone completed it.

• Staff had limited support to understand how to protect patients from abuse. Not all staff had training on how to recognise and report abuse.

• The service did not control infection risk well. Staff did not use equipment and control measures to protect patients, themselves and others from infection. Equipment was visibly dirty.

• The maintenance and use of facilities, premises, vehicles and equipment did not always keep people safe. Staff did not manage clinical waste well.

• We were unable to gain assurances that staff received adequate training to enable effective identification and timely escalation of patients at risk of deterioration.

• The service had enough staff, but we could not find evidence they had the right qualifications, skills, training and experience to keep patients safe from avoidable harm and provide the right care and treatment.

• The service did not have effective systems and processes in place to safely prescribe and administer medicines.

• The service did not always provide care and treatment based on national guidance and evidence-based practice. Managers did not check to make sure staff followed guidance.

• The service did not make sure staff were competent for their roles. There were no appraisal systems in place to review staff’s work performance and supervision meetings with them to provide support and development had not taken place.

• Leaders did not have the skills and abilities to run the service. They lacked understanding of effective management techniques to address the priorities and issues the service faced. There was a lack of support for staff to encourage development in skills.

• Leaders did not operate effective governance processes. Staff at senior levels were not clear about their roles, responsibilities and accountabilities. There was limited evidence to demonstrate that regular opportunities to meet, discuss and learn from the performance of the service had taken place.

• Leaders did not effectively use systems to manage risks effectively. Risks lacked identified timescales to reduce their potential or actual impact.

Following this inspection, the service informed us they would voluntarily cease to provide regulated activities. Due to our inspection findings on 6 October 2020, we served an urgent notice to suspend the registration as a service provider in respect of regulated activities.

On 22 October 2020, the previous enforcement action (notices of proposal to cancel their registration and the manager’s registration ) representations period elapsed and the provider’s registration with us has now been cancelled. The provider is no longer registered to transport patients.

We did not rate this service during the inspection on 6 October 2020 due to the focused nature of our enquiries. The previous inspection rating was inadequate overall in October 2019.

Heidi Smoult

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