The Care Quality Commission (CQC) has rated LSA House, an independent ambulance service based in Cookham, Maidenhead, inadequate overall, and has imposed conditions on the registration of the service to keep people safe.
The service has also been rated inadequate in relation to whether it is safe, effective and well-led. It has been rated requires improvement for its responsiveness to people’s needs, but it has not been rated in the caring domain, as there was insufficient evidence to do so.
LSA House is an independent ambulance service operated by LSA Secure Limited. It is registered to provide a patient transport service and predominantly provides secure transportation for patents with mental health conditions. In June 2020, the provider amended its registration so that it could also offer an emergency and urgent care service during the COVID-19 pandemic. At the time of the inspection, it had not delivered any emergency and urgent care.
This was the first inspection of LSA House since the provider registered with CQC in 2018.
Cath Campbell, CQC’s head of hospital inspections, said:
“We had numerous concerns following our recent inspection of LSA House and we have told the provider that it must take action to ensure that the service complies with legal requirements in order to keep people safe.
“We have now imposed conditions on the registration of both of the core services that the provider offers, namely patient transport and urgent and emergency care. We have told the provider that it must send us a report outlining what action it intends to take to address our concerns. We will continue to monitor the service to ensure that improvements are made and fully embedded.”
Inspectors found the following areas of concern.
The governance and leadership of the service did not fully protect the safety of patients:
- The service did not control all areas of infection risk well
- Staff did not keep detailed records about the use of restraint on patients and they did not always complete patient risk assessments
- Patient safety incidents were not managed well and the use of restraint on patients was not considered to be an incident
- Staff did not always ensure that restraint equipment was safe to use
- Safeguarding of patients from abuse and improper treatment was not fully assured
- Guidance for staff was not clear. Policies and procedures did not always relate to the service provided
- Staff did not fully understand their role in supporting patients who lacked the mental capacity to make decisions
The governance and leadership of the service did not always manage performance, nor did it use monitoring of the service to support ongoing improvements which could potentially put patients at risk of avoidable harm.
- There were no processes to get feedback from organisations who used the service and there were limited processes for people to give feedback and raise concerns about care
- The service did not have a system to effectively manage risks or audit the quality of the service. Data was not used to understand performance and to make decisions and improvements
- The service did not have structured meetings to ensure performance was reviewed.
However, the service had enough staff to care for patients and people could access the service when they needed it. Staff felt respected and valued and they demonstrated understanding about the discrimination that mental health patients may experience.
Full details of the inspection are given in the report published on our website.
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