Archived: NECHS Also known as North East Community Health Limited

North East Community Health Services (NECHS) is operated by the provider, which is also called North East Community Health Services. The company provides emergency and urgent care and a patient transport service. They also provide medical cover at public and private events. We did not inspect this part of the service as it is not currently a regulated activity.

The main service provided was emergency and urgent services and a small proportion of activity attributed to patient transport services; therefore, we have reported our findings in relation to the patient transport services section, in the emergency and urgent care section.

We inspected this service using our comprehensive inspection methodology. We carri ed out the announced inspection on 10 May 2018.

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 stated and how the provider understood and complied with the Mental Capacity Act 2005.

S e r v ices 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 provider needs to improve:

· The provider’s policy and procedures for the management and investigation of incidents was not robust.

· There was no mandatory training framework in place for staff and no process to ensure care and treatment provided was in line with national guidance and best practice.

· Safeguard policies and processes were not service specific and were not in line with Adult Safeguarding Levels and Competencies for healthcare, Intercollegiate guidance (2016).

· Risk assessments were not reflective of the current concerns and the provider did not have processes in place to regularly review and mitigate risk.

· Patient care records were not completed in a consistent manner and audit processes were not established to identify gaps.

· We did not see clear treatment guidelines to ensure staff worked within their professional boundaries and provided safe care and treatment.

· Crew did not receive mandatory rest breaks in line with Working Time Regulations 1998.

· We reviewed 40 of the 60 provider’s policies and saw they were not service specific and contained references to other providers.

· Response times were not formally monitored and processes were not in place to drive improvement for the service.

· Staff supervision was not provided in accordance with the provider’s policy and we did not see evidence of any recorded clinical supervision.

· Essential employment checks, including disclosure and barring service checks were not clearly recorded in the staff files we checked.

However, we also found the following areas of good practice:

· The environment was clean and well organised and there were clear infection control protocols in place.

· Staffing levels were sufficient to support on-going services and future expansion.

· Staff stated they were committed to providing the best care and treatment for their patients and strongly believed in the first response vision.

· The provider had developed networking relationships with local universities and professional providers.

· The provider had business continuity plans in place and the ability to relocate, in the event of a major incident.

Following this inspection, we issued the provider with a warning notice. Details of this notice can be found at the end of the report. We also issued the provider with six requirement notices that affected the patient transport and urgent and emergency services. Details are at the end of the report.

Ellen Armistead

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