28 July 2017
During a routine inspection
South West Specialist Medics is operated by Southwest Specialist Medics Ltd. The service provides a patient transport service, as well as an emergency and urgent care service at events. Event only work is currently outside our scope of registration; therefore, we did not inspect this area of the provider’s service.
We inspected this service using our focused inspection methodology. We carried out an inspection on 28 July 2017 with 24 hours’ notice given to the provider to follow up on concerns we had received. We attempted to revisit the service and inspect further on 8th August 2017, but were unable to get a response when we arrived.
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? We did not inspect caring or responsive as part of this inspection, and due to significant concerns being found in the safe, effective and well-led domains we were unable to inspect these domains in their entirety.
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 are currently undertaking enforcement action against this provider and will publish the details of this once the processes have concluded. Following the inspection, a letter of concern was sent to the provider, detailing key concerns.
During this inspection we found:
- Incidents that affected the health, safety and welfare of people using services were not investigated and actions were not taken to prevent recurrences.
- There was no record keeping for medicines being kept by the registered manager.
- Medicines were not stored securely.
- We found some consumables were out of date, including testing strips for blood glucose machines.
- There were no procedures or processes in place to make sure people were protected from abuse. There was no scrutiny or oversight of safeguarding.
- Although there was a safeguarding policy it was not fit for purpose. There was no evidence staff had read the policy or had received training in safeguarding.
- The ambulance was not kept clean. There was physical dirt and dust in the vehicle and in some areas there was rust.
- Equipment in the ambulances did not have service stickers on them and we could not get assurance from the provider that they were safe to use.
- There were no cleaning schedules or evidence that cleaning had taken place in any of the ambulances.
- There were no systems and processes in place for the provider to monitor the service against the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
- There were no systems or processes in place such as regular audits of the service to assess, monitor, and improve the quality and safety of the service.
- There were limited processes in place to seek feedback from people who used the services. When feedback was received there was no processes in place to share the feedback with staff or make improvements to the service.
- There were no policies and procedures for obtaining consent to care and treatment. There was no documentation, for example a patient care record, to confirm consent had been gained for care or treatment.
- The registered manager was unable to demonstrate they had the appropriate knowledge of applicable legislation including the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
- The registered manager could not provide any assurance that the Health and Social Care Act was being adhered to.
- Some policies and procedures used by the organisation were copied from other organisations and had not been adapted to make them fit for purpose for the provider. These included the medicines management policy, the medicines competency assessments, and the risk register.