Archived: Jigsaw Medical-Hampshire Resource Centre

Updated 5 December 2018

Jigsaw Medical-Hampshire Resource Centre is operated by Jigsaw Medical Service Ltd. The service opened in 2012 and is an independent ambulance service with the head office in Chester, Cheshire. The service has expanded and has ambulance bases situated in Warrington, Buckingham and Basingstoke. The service serves a number of communities including, Greater Manchester, Cheshire, Merseyside, Yorkshire, East Midlands, Buckinghamshire, Oxfordshire, Berkshire and Hampshire.

The service provides emergency and urgent care to a number of NHS ambulance trusts and is provided in dedicated emergency vehicles. The patient transport service provides support to several ambulance trusts as well as NHS acute hospital trusts and individual patients. The service consists of both contract and ad hoc work.

Jigsaw Medical Services also provide an ad hoc events’ support service to sports events and festivals. On-site event cover is not a regulated activity and we have no powers to regulate it, so it did not form part of this inspection.

The provider is registered with the Care Quality Commission (CQC) to provide the following regulated activities:

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

Since October 2017, the managing director was the service’s registered manager (RM). Prior to this the RM had been the chief executive officer.

We completed an announced inspection of Jigsaw Medical-Hampshire Resource Centre, based in Basingstoke, on 29 August 2018.

Updated 5 December 2018

Jigsaw Medical – Hampshire Resource Centre, based in Basingstoke, is an ambulance service providing emergency and urgent care services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 29 August 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 told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided was emergency and urgent care, therefore we have reported findings in the emergency and urgent care core service.

We found the following areas of good practice:

• The provider had strong leadership with a clear focus on high quality provision and care.
• We found all vehicles were in good condition and there was a comprehensive system to ensure they were fit for purpose.
• There was an effective compliance process to ensure operational staff had completed induction and mandatory training before commencing employment and remained competent during the time they continued to work for the provider.
• There were arrangements for escalating issues with contracting trusts. A contract manager was identified within the commissioning trust and monthly contract meetings took place to monitor performance and provide feedback regarding incidents and referrals.
• Mental Capacity Act 2005 training compliance was 100% for operational staff at the time of our inspection.
• Staff had access to practitioners trained in Trauma Risk Management (TRiM) to support personnel following traumatic events. TRiM is a peer delivered psychological support system designed to allow organisations to proactively support personnel following traumatic events.

However, we also found the following issues that the service provider needs to improve:

• The provider did not have oversight of all incidents and safeguarding situations operational staff. They relied on the commissioning trust to identify any immediate learning by telephone or during monthly contract meetings. The provider did not have a complete record of all incidents or safeguarding referrals reported.
• Medicine storage temperatures were not effectively monitored in store rooms and on vehicles.
• Not all staff had received an appraisal. Documentation we reviewed did not indicate any standards and although there was a scoring system for individuals, there was no indication of what the scores meant.
• Patient feedback forms were not available on all vehicles we inspected. Staff were not always involved in complaints from the commissioning trust and did not always receive feedback on complaint outcomes.

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.

Dr Nigel Acheson

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

Updated 5 December 2018

The main service provided was an ambulance service providing emergency and urgent care services.

The provider had strong leadership with a clear focus on high quality provision and care.

There were arrangements to escalate issues with commissioning trusts.

Staff were committed to providing the best quality care to patients.

However, the provider did not have a record of all incidents or safeguarding referrals reported through trust processes therefore did not have oversight of all incidents and safeguarding situations operational staff had been involved in.

The provider did not have a robust system to monitor storage temperatures of medicines.