The Care Quality Commission
  • Ambulance service

Archived: Mobile Medical Cover

Overall: Inadequate read more about inspection ratings

Unit 10, New Clee Ind Est., Spencer Street, Grimsby, DN31 3AA (01472) 739998

Provided and run by:
Mobile Medical Cover Ltd

All Inspections

16 May 2022

During a routine inspection

We rated this location as inadequate because:

  • The service failed to ensure robust infection prevention control measures were in place which follow current government guidance and legislation.
  • The service failed to ensure risk assessments for patients using the service including plans for managing risks were completed, recorded and audited to provide evidence doing all that is reasonably practicable to mitigate risk.
  • The service continued to demonstrate poor management of medicines and medical gases including storage, dispensing, administration, recording and disposal in line with best practice guidance.
  • The service failed to share outcomes of incident investigations with the patient, their families and carers and their own staff.
  • The service continued to be unable to demonstrate the implementation of an effective system and process to ensure the premises and equipment including each vehicle and the equipment carried on it is clean, safe, well maintained and fit for purpose.
  • The service managers continued to be unable to demonstrate a full understanding of their roles and responsibilities and the duties delegated to them by the Health and Social Care Act 2008.
  • The service continued to be unable to demonstrate effective governance systems and oversight supported by clearly defined audit of systems and processes.
  • The service failed to ensure effective systems were in place to assess and monitor the quality of care for patients.
  • The service continued to be unable to demonstrate staff were recruited in accordance with Schedule 3 requirements of the Health and Social Care Act 2008 (Regulations) 2014.

Following the inspection CQC took enforcement action using our urgent powers whereby we suspended the provider’s registration until 19 August 2022 under section 31 of the Health and Social Care Act 2008 as people may or will be exposed to the risk of harm. This was to immediately protect patients from the risk of harm and to give the provider the opportunity to put in place urgent actions to address our concerns.

We also issued a notice of proposal to cancel the registrations of the provider and registered manager on 30 May 2022. The provider submitted representations to appeal the notices on 02 June 2022. The representations were not upheld regarding the cancellation of the provider and a notice of decision to cancel the registration of the provider was issued on 06 July 2022

The provider did not appeal the notice of decision to cancel the provider registration. Therefore, the notice of decision to cancel the registration of the provider took effect on 12 August 2022.

9 February 14 February

During an inspection looking at part of the service


• The service failed to ensure sufficient infection prevention and control (IPC) measures to mitigate the risks of infection, exposing patients to the risk of harm.
• The service failed to ensure effective systems for the storage, administration and reconciliation of medicines, including medical gases.
• The service failed to demonstrate that systems or processes were established and operated effectively to ensure compliance with the regulations.
• The maintenance and use of facilities, premises, vehicles and equipment did not keep people safe.
• Leaders could not demonstrate they had the skills and abilities to run the service. They could not articulate they understood and how they managed the priorities and issues the service faced.
• Leaders could not demonstrate how they operated effective governance processes, throughout the service.

Following the inspection CQC took enforcement action using our urgent powers whereby we suspended the provider’s registration under section 31 as people may or will be exposed to the risk of harm until 15 May 2022. The provider applied to have the suspension removed. CQC agreed to this application only after receiving evidence showing the provider had taken action to address the areas of concern which put people at risk of harm.

10 August 2021

During a routine inspection

We rated this service as inadequate because:

The service did not control infection risk well.

Staff did not thoroughly assess or record risks to patients.

Staff required to transport patients from events were not recruited in accordance with Schedule 3 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service did not manage or store medicines, including medical gases, safely.

We did not see evidence the service had processes in place to share lessons learned from safety incidents.

Fire and health and safety risks had not been addressed at the service’s premises.

Managers did not adequately monitor the effectiveness of the service.

Not all staff had access to information such as company policies and procedures.

Leaders did not always run services well using a reliable information system.

Staff did not understand the service’s vision and values, or how to apply them in their work.

Staff were not always clear about their roles and accountabilities.

The service did not engage well with the community to plan, manage and improve services.

However:

The service had enough staff to care for patients.

Patient transport staff had training in key skills and understood how to protect patients from abuse.

Staff appeared caring and worked together to provide effective care.

Key services were available seven days a week.

The service had several mechanisms in place for people to give feedback.

Although we saw some areas of improvement following our inspection in October 2020, we were concerned there were still areas which had not been adequately addressed in relation to safe care and treatment, the environment, and the service’s governance processes. As a result, we wrote to the provider to issue a warning notice relating to these issues. Representations were submitted following this which were independently reviewed and were not upheld.

The warning notice was served to the provider on 19 August 2021 under Section 29 of the Health and Social Care Act 2008, in respect of the regulated activities: transport services, triage and medical advice provided remotely; and treatment of disease, disorder or injury. It related to: Regulation 12, (2), Safe care and treatment; Regulation 15, (1), Premises and equipment; and Regulation 17, (1), Good governance, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We specified the date by which the provider was required to become compliant with these regulations.

7th October 2020

During an inspection looking at part of the service

Mobile Medical Cover is operated by Mobile Medical Cover Ltd. The service is registered to provide emergency and urgent care and a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced focussed inspection on 7 October 2020 covering the safe and well-led domains.

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 by this ambulance service was patient transport. 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 section.

The service was not rated because not all domains were inspected.

Following this inspection, we told the provider that it must take 37 actions to comply with the regulations and that it should make 35 other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices that affected patient transport services and emergency care and urgent care. Details are at the end of the report.

We found the following areas in which the provider needs to improve:

  • Training records for staff were not complete.
  • There was no assurance the provider had oversight of who had completed the required mandatory training, and when updates and refreshers were due.
  • At the time of the inspection the safeguarding lead only had a level two safeguarding qualification.
  • There was no evidence of a regular cleaning supported by auditing to support this.
  • The two ambulances we inspected were displaying external information which was headed with an alternative company’s name/logo which was not the company name.
  • The provider did not have a deteriorating patient policy or a patient eligibility criteria policy.
  • We were unable to evidence if 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 because the training records were incomplete.
  • The provider did not complete patient record forms (PRF`s) for patient transport service (PTS) patients.
  • There was no evidence the provider made sure that up-to-date do not attempt cardiopulmonary resuscitation (DNACPR) orders and end of life care planning was appropriately recorded and communicated when patients were being transported because the provider did not complete PRF`s.
  • The provider did not have a clear vision and set of values.
  • The provider did not carry out regular audit activity.
  • The provider did not have a staff appraisal system.