Archived: KFA Medical

Updated 3 September 2021

KFA Medical first registered with the CQC on 14 June 2013. The service is an independent ambulance service based in Keighley, West Yorkshire.

The company provided a range of services including; urgent and emergency paramedic and first aid medical coverage at both private and public events; blood and organ transport; first aid training, repatriation of patients all of which are not currently regulated by CQC. The company also provided patient transport services which is regulated by CQC.

In January 2021, CQC received information of concern about KFA Medical Ltd. A decision was made to carry out an unannounced focused inspection of the safe and well-led domains to investigate the concerns.

Following the January 2021 inspection, we issued the provider with a notice of decision on 15 January 2021, to urgently suspend the provider's registration to carry out regulated activity until 14 March 2021. This was due to risks identified regarding patient safety identified during the inspection. We told the provider that it must take 24 actions to comply with the regulations and should take one action even though a regulation had not been breached, to help the service improve.

Following the unannounced inspection on 10 and 11 March 2021, we issued the provider with a notice of decision on 12 March 2021, to urgently suspend the provider's registration to carry out regulated activity until 14 June 2021. This was due to risks identified during the inspection regarding patient safety. We told the provider that it must take 20 actions to comply with the regulations and should take one action even though a regulation had not been breached, to help the service improve.

This inspection was an unannounced focused inspection of the safe and well-led domains to gain assurance the provider had acted in response to the issues highlighted in the notice of decision to urgently suspend the provider's registration to carry out regulated activity.

Updated 3 September 2021

Due to the nature of the inspection we inspected but did not rate the service.

We found the following areas where the provider needs to improve;

The provider still did not have a mandatory training policy. There was no assurance mandatory training and key skills was provided to all staff. We found no evidence of any completed training in one staff file.

Staff could not demonstrate they understood how to protect patients from abuse. There was no evidence the service worked with other agencies to do so. The provider’s safeguarding policy contained no clear guidance for staff to follow as to the correct procedure to report a safeguarding concern.

The service did not control infection risk well. Staff did not use equipment and control measures to protect patients, themselves and others from infection. Staff were unable to evidence they were operating a safe infection prevention and control system.

The design, maintenance and use of facilities, premises, vehicles and equipment did not keep people safe. Equipment, vehicles and premises were visibly dirty.

Staff completed risk assessments for patients, but the provider had no specific eligibility criteria to ensure patient transport services (PTS) staff were competent to meet patient’s needs.

Staff did not have the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Some disclosure and barring service (DBS) checks of employees were not up to date or had not been obtained when employees applied to work for KFA Medical Ltd. This meant we could not ensure staff were fit and proper and of the necessary character to work for the provider.

The service could not demonstrate it followed best practice or used systems and processes safely when recording and storing patient’s own medicines. The provider’s medications policies were confusing and did not reference one another.

The service did not manage patient safety incidents well. There was no formal process in place to share learning from incidents.

Leaders could not demonstrate they had the skills and abilities to run the service.

Leaders could not demonstrate how they operated effective governance processes. The registered manager could not answer questions in relation to company policies. The provider had drafted first versions of over 30 new policies and procedures since our last inspection on 10 March 2021. The majority of the provider’s policies remained generic and were non-service specific with references to reporting and recording systems the provider did not have. The policies lacked vital detail on processes and guidance staff should follow.

Leaders and teams could not evidence how they used systems to manage performance effectively. They could not articulate how they identified and escalated relevant risks and issues.

The service did not collect reliable data or analyse it. Staff confirmed the provider had no retention of records policy.

After this inspection we served the provider a notice of decision under Section 31 of the Health and Social Care Act 2008 to formally notify them their registration as a service provider in respect of the above regulated activities will be further suspended from 11 June 2021 until 11.59pm on 6 September 2021. This followed the provider’s original suspension period from 15 January 2021.

We were concerned given the lack of improvements seen to date since our inspection in January 2021 of the service being managed. As a result, we proposed to cancel the registration of the manager and provider in respect of the regulated activities; Transport services, triage and medical advice provided remotely and; Treatment of disease, disorder or injury. This notice was served under Section 26 of the Health and Social Care Act 2008. There was no representations submitted following the notice of proposal and as a result, we issued a notice of decision to cancel the registration of the manager and provider in respect of the regulated activities; Transport services, triage and medical advice provided remotely and; Treatment of disease, disorder or injury was served under Section 26 of the Health and Social Care Act 2008.

Updated 3 September 2021

Due to the responsive nature of this inspection we did not rate the service.

We found the following areas where the provider needs to improve;

The provider still did not have a mandatory training policy. There was no assurance mandatory training and key skills was provided to all staff. We found no evidence of any completed training in one staff file.

Staff could not demonstrate they understood how to protect patients from abuse. There was no evidence the service worked with other agencies to do so. The provider’s safeguarding policy contained no clear guidance for staff to follow as to the correct procedure to report a safeguarding concern.

The service did not control infection risk well. Staff did not use equipment and control measures to protect patients, themselves and others from infection. Staff were unable to evidence they were operating a safe system.

The design, maintenance and use of facilities, premises, vehicles and equipment did not keep people safe. Equipment, vehicles and premises were visibly dirty.

Staff completed risk assessments for patients, but the provider had no specific eligibility criteria to ensure patient transport service (PTS) staff were competent to meet patient’s needs.

Staff did not have the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Some disclosure and barring service (DBS) checks of employees were not up to date or had not been obtained when applying to work for KFA Medical Ltd. This meant we could not ensure staff were fit and proper and of the necessary character to work for the provider.

The service could not demonstrate it followed best practice or used systems and processes safely when recording and storing patient’s own medicines. The provider’s medications policies were confusing and did not reference one another.

The service did not manage patient safety incidents well. There was no formal process in place to share learning from incidents.

Leaders could not demonstrate they had the skills and abilities to run the service. The external governance consultant expressed doubts about the registered manager’s abilities and understanding in how they carry out their role.

Leaders could not demonstrate how they operated effective governance processes. The registered manager could not answer questions in relation to company policies. The provider had drafted first versions of over 30 new policies and procedures since our last inspection on 10 March 2021. Generally, the provider’s policies were generic, non-service specific and some read as if for a larger organisation with references to reporting and recording systems the provider did not have. They lacked vital detail on processes and guidance staff should follow.

Leaders and teams could not evidence how they used systems to manage performance effectively. They could not articulate how they identified and escalated relevant risks and issues. The provider’s designated lead in multiple areas was one person not directly employed by the provider

The service did not collect reliable data or analyse it. Staff confirmed the provider had no retention of records policy.

However, we did find the following areas of good practice;

The service had a designated or nominated lead for safeguarding, infection prevention control (IPC), investigations, complaints, freedom to speak up, litigation, governance and risk management. This lead planned to share their governance approach and experience with staff until the service was self-sufficient.

The service had a vision for what it wanted to achieve.

Staff we spoke with felt respected, supported and valued.