Archived: SSG UK Specialist Ambulance Service - South

Updated 9 April 2019

SSG UK Ambulance - South is operated by SSG UKSAS. The service was registered in 2017 It is an independent ambulance service in Fareham, Hampshire. The provider has two other locations with their headquarters situated in Rainham Essex. SSG UK Ambulance -South primarily serves the communities of the Hampshire, Southampton and Portsmouth areas.

The service has had a registered manager in post since August 2017. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage a service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how a service is managed.

The service is registered to provide the following regulated activities:

• Triage and medical advice provided remotely

• Treatment of disease, disorder or injury.

Updated 9 April 2019

This report describes our judgement of the quality of care at this location. We based it on a combination of what we found when we inspected and from all information available to us, including information given to us from people who use the service, the public and other organisations.

SSG UK Ambulance - South is operated by SSG UKSAS. The service provides emergency and urgent services and patient transport service. Most of services provided are commissioned by NHS trusts.

Following our inspection on 23 August and 04 September 2018, we rated the service as inadequate and placed it in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

We also served the provider with two warning notices relating to breaches for safe care and treatment and governance. The provider was required to be compliant and make the necessary improvements by 23 November 2018.

We carried out an unannounced focus inspection at the provider’s headquarters in Rainham, Essex on 28 November 2018 and the Fareham station on 6 November 2018, to review compliance with the two Warning Notices. We did not look at all the domains and key questions, instead we focused on specific areas of concerns in the Warning Notices.

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.

Our inspection targeted the key concerns identified in the warning notice.

At our inspection we found the provider had not made progress on all issues identified in the warning notice. Issues outstanding were;

• Medicines including controlled drugs (CDs) were not managed safely and in line with best practice guidelines which may impact on the safety of patients.

• There were no audits of CDs which were stored off site and individual paramedics’ CD registers audits were not consistently undertaken. We found that compliance with installation and storage of home CDs had not been assessed for all paramedics storing CDs off site.

• The provider was considering re introducing administration of medicines via patient group directions. However, the procedures and staff training had yet to be developed.

• The provider was unable to produce accurate data relating to the number and batch number of CD ampoules issued to individual paramedics.

• Policies for the management of medicines had been developed; however, this was not currently effectively managed as the staff could not access these.

• The process for managing risks was not effective, risks were not consistently identified and action plans developed to mitigate these. The management team were not aware of the serious risks we identified during the inspection.

• There were significant risks of misappropriation of CDs as staff who had left the service remained in possession of CDs and had not been returned to the service.

• The process for the use of patient group directions (PGD) had not been resolved as these had not been fully developed in line with National Institute for Health and Care Excellence (NICE) guidelines and approved for use. These have not been approved by commissioners.

However, they had addressed the following issues in the warning notice:

• The meeting including monthly board meetings and committee structure had been developed but not implemented at the time of our inspection. Procedures for sharing this information with the staff were being developed but not implemented at the time of the inspection.

• The provider had suspended the destruction of CDs and other medicines while they develop procedures for their safe destruction.

Following this inspection, we concluded the provider was not compliant with all aspects of the warning notice.

Following this inspection, we told the provider that it must take some actions to comply with the regulations. We also issued the provider with two requirement notice(s) that affected SSG UK Ambulance - South . Details are at the end of the report.

Name of signatory

 Dr Nigel Acheson

Deputy Chief Inspector of Hospitals

Updated 29 November 2018

Patient transport services were a small proportion of activity provided. The main service was urgent and emergency services. Where services were the same we have reported this in the urgent and emergency care section.

We have rated safe, effective and well led as inadequate. Responsive is rated as requires improvement. The caring section has not been rated, as we do not have enough information to rate this section. There were no patients receiving care during the inspection. We were unable to observe care and speak to patients.

Updated 9 April 2019

Urgent and emergency services were the main service provided. The majority of the service was carried out under contract with NHS ambulance trusts.

We have not rated the service at this inspection as we were reviewing the provider’s compliance with the two Warning Notices.