07 June 2021
During an inspection looking at part of the service
We have placed this service in special measures due to their need to make significant improvements. We have also suspended the provider from providing regulated activity for a six month period. This means the service cannot continue to operate until it makes significant improvements. On 6 July 2021 we received an application from the provider to deregister from providing regulated activity. We are currently processing this application.
We inspected the service on 28 April and 4 May 2021, we were so concerned about its quality and safety that we suspended their registration for six weeks, preventing it from operating. We also issued a warning notice in relation to breaches of the regulations that we found.
On 7 June 2021 we carried out a focused inspection to see if the service complied with the regulations it was not meeting at our previous inspection. We gave 48 hours’ notice of the inspection due to the service’s opening times being variable and operating on different days and times of the week.
We found;
Our rating of this location stayed the same. We rated it as inadequate because:
- There were still no reliable systems to ensure all staff were appropriately trained, qualified and competent to provide safe care. The safeguarding procedure was not available to review so there was no evidence it had been updated. There was minimal evidence the service was now assured fit and proper persons were employed to protect patients from abuse. The provider did not have robust processes to ensure infection risk was controlled well.
- The provider could still not be assured care and treatment was in line with national guidance. There was still no evidence of audits being planned in line with the identified requirement in the service’s policies. Reviewed policies and procedures were not always correct. Staff were still not supported to develop their skills.
- The provider still did not take into account peoples individual needs.
- Leaders did not demonstrate they had the capability to ensure the care and treatment provided was safe and of high quality. There was no registered manager in place and no individual with capacity to oversee the improvement process was identified. Leaders did not demonstrate they had the understanding of the safety and business priorities and how to manage them. There were still no reliable and consistent systems to provide oversight of safety and quality of care delivered. There was still no consistent, embedded system for reviewing risks. Leaders were still not clear about their legal responsibilities of providing care under the regulated activities.
However:
- The provider had made some practical improvements in the environment and equipment availability. Some cleaning and equipment checking processes had been improved.
- The provider had introduced a process to make staff aware of any updates to legislation, standards and evidence-based guidelines.
- A fleet manager was identified to ensure ambulances were appropriately serviced and had annual safety checks.
- Remote access to Joint Royal Colleges Ambulance Liaison Committee (JRCALC) was put in place to allow staff access to guidelines at all times.
- All staff we spoke with displayed a commitment to improve the service.