Archived: Secure Care Uk

Updated 23 April 2018

Secure Care UK (SCUK) is operated by Mr Sam Alan Bull. The service opened in 2013. It is an independent ambulance provider in Hastings, East Sussex.

The types of transport provided include: transfers from secure mental health services to prisons or courts; transfers from mental health inpatient units to general acute settings for medical care; transport from patients’ home addresses to a mental health inpatient setting and transfers for patients using community mental health services and learning disability services. The service also provided bed watches on mental health wards and monitored patients at section 136 suites. A section 136 suite is a dedicated unit for the reception and assessment of patients with mental health disorders.

SCUK provides patient transport services to a number of NHS trusts and private providers across England, Scotland and Wales. The service completed 3,233 patient journeys between September 2016 and August 2017.

SCUK only transport adults aged 18 or over, and stopped transporting children and young people in November 2017 following concerns identified at our previous inspection in October 2017. The provider subsequently suspended all services for children and young people. The provider has no plans to reintroduce the transport of children and young people until it had achieved full regulatory compliance.

The service has had a registered manager in post since 2013; this individual also became the Managing Director of the provider in 2014. During this inspection, we were told the training manager would be applying for the position of registered manager.

Updated 23 April 2018

Secure Care UK (SCUK) is operated by Mr Sam Alan Bull. The service provides a patient transport service for adults with mental health disorders, as well as the transport and supervision of people in section 136 suites whilst awaiting mental health assessment.

We carried out an announced inspection on 5 February 2018 to follow up on our previous concerns about the service. This report looks specifically at those concerns and so does not cover all of the areas of our comprehensive inspection methodology.

We completed an announced inspection of SCUK on 17 October 2017, along with an unannounced inspection on 25 October 2017. We found the following issues:

• The provider did not adequately investigate incidents and there was no evidence of shared learning. 
• Staff at this ambulance station did not always complete the cleaning and vehicle safety checklists.
• The external door to the ambulance station was open on arrival at the unannounced inspection. 
• The provider did not have equipment for children and young people.
• Oxygen cylinders were stored incorrectly.
• Managers lacked awareness of an understanding of safeguarding children and adults at risk.
• There was ineffective storage of patient records. 
• Some of the policies and guidance were not specific to the roles, responsibilities and type of service provided.
• There were no policies or guidance for the transport of children, monitoring at 136 suites and bed watches. 
• Staff were unaware of how to contact the translation service.
• Staff were unaware of the organisation’s visions and strategy for the service.
• Governance arrangements were not of a good enough standard to identify and minimise risks. There was a lack of oversight and self-assurance of compliance with the fundamental standards.

Because of the above, CQC issued the provider with a warning notice in November 2017 because the provider was not compliant with Regulation 17, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We told the provider that they must be compliant with this regulation by 7 December 2017.The provider was also issued with two requirement notices.

We carried out this inspection to review what actions had been taken by the provider to respond to CQC’s concerns about the governance of the service. This included reviewing the progress made in accordance with the action plan, which the provider submitted to CQC following the previous inspection.

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 that the provider had made some improvement on the concerns listed above.
• The ambulance station was secure with restricted access through the internal doors.
• The provider had obtained equipment for children and young people.
• Oxygen cylinders were stored correctly. 
• The safeguarding lead had the correct level of safeguarding training and fully understood the provider’s duty to report safeguarding concerns. 
• Leadership within the organisation had changed but it was too soon to establish the effectiveness of these changes.

However:

• At the time of inspection, there had been little progress to address our previous concerns about incident management.
• The organisation had not met its requirement to apply the duty of candour for incidents.
• There was still poor staff compliance to the completion of vehicle cleaning and safety checklists. 
• At the time of inspection, the provider had not implemented changes to improve patient assessment and record keeping.
• The provider had not reviewed and updated policies to reflect changes made to practice.
• Staff remained unaware of how to contact the translation service.
• There was still poor compliance to first aid training.
• Management acknowledged information provided to CQC at the previous inspection was incorrect.
• At the time of inspection, there had been little progress to address our previous concerns about recruitment checks.

We sent the provider a letter highlighting our concerns following this inspection. We requested and received an action plan, which addressed each area for improvement. The action plan is discussed in more detail throughout the report.

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 notice(s) that affected the patient transport service. Details are at the end of the report.

Amanda Stanford

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

Updated 18 December 2017

Secure Care Uk specialised in the transport of adults, children and young people (CYP) with mental health disorders. It also monitored service users in 136 suites and occasionally provided bed watches. The service operated from a single location in Hastings, but the service had micro bases throughout England.