• Ambulance service

Archived: Unit 1

Overall: Good read more about inspection ratings

Snaygill Industrial Estate, Keighley Road, Skipton, North Yorkshire, BD23 2QR (01756) 802112

Provided and run by:
Mr. David Ogden

Important: The provider of this service changed. See new profile

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Background to this inspection

Updated 6 April 2020

Unit 1 is operated by Mr. David Ogden. The service opened in 2010. It is an independent ambulance service in Skipton, West Yorkshire and operates throughout the UK. The company provides urgent and emergency paramedic and first aid medical coverage at both private and public events, as well as patient transport supplying up to two ambulances and crew per day on an “as required basis” to a remote acute hospital. There is currently no contract in place.

The service was registered to provide the following regulated activities since 12 January 2018:

  • Treatment of disease, disorder or injury

  • Transport services, triage and medical advice provided remotely

Mr David Ogden first registered with the CQC in October 2010. The service has had a registered manager in post since 2010.

Overall inspection

Good

Updated 6 April 2020

Unit 1 is operated by Mr. David Ogden. The service provides non 999 responder emergency and urgent care and patient transport services.

We undertook a comprehensive inspection of the service on 28 and 29 January 2020.

The service was rated as good overall.

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 and inspected was patient transport services. Where our findings on patient transport for example, management arrangements also apply to other services, we do not repeat the information but cross-refer to the patient transport care core service using this statement: See Patient Transport for main findings.

Our rating of this service improved. We rated it as Good overall, we found the following areas of good practice:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment, vehicles and premises visibly clean.

  • The design, maintenance and use of facilities, premises, vehicles and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.

  • The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix and gave bank, agency and locum staff a full induction.

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.

  • The service managed patient safety incidents well. Staff recognised incidents and near misses and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team, the wider service and partner organisations. When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured that actions from patient safety alerts were implemented and monitored.

However, we found the following issues in relation to medicines management which the provider needed to improve:

  • The medicines management policy was not fit for purpose

  • Medicines stocks and medicines stored in bags included out-of-date items.

  • Checks of controlled medicines were not documented accurately and an up-to-date register of controlled medicines was not maintained.

  • Patient Group Directions which were being used did not conform to legal requirements.

  • We found a lack of assurance as to the safety of medicines being stored in the medicine fridge.

  • Medical gases were not stored safely.

  • Medicines audits were not robust as stock checks were not completed each month and the audit completed a few days prior to this inspection had not identified the out of date medicines.

  • Governance arrangements for the management of medicines were not robust or consistent.

We shared our concerns as to the safety of medicines management with the provider at the inspection and the provider undertook to take immediate action to mitigate the risks identified to ensure the safety of the service.

Following this inspection, we told the provider that it must take eight actions to comply with the regulations and that it should make two other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with two requirement notices that affected both emergency and urgent care and patient transport services. Details are at the end of the report.

Sarah Dronsfield

Head of Hospitals Inspection North East, on behalf of the Chief Inspector of Hospitals

Patient transport services

Good

Updated 6 April 2020

Patient transport services was the main proportion of activity. The organisation provided the service at one remote acute hospital. It provided up to two ambulances and crews daily as required.

The provider undertook 709 patient transfers between August 2019 and December 2019.

We found evidence of compliance in the effective, caring and responsive domains but improvements were required for the safe management and governance of medicines.

Emergency and urgent care

Good

Updated 6 April 2020

The organisation provided emergency and urgent care paramedic and first aid medical coverage at both private and public events. At the time of the inspection, the provider did not have a contract with any NHS or independent provider to provide emergency and urgent care.

Where arrangements were the same, we have reported findings in the PTS section.