Location Medical Services - Shepperton Studios Medical Centre

Updated 26 March 2020

Location Medical Services - Shepperton Studios Medical Centre is operated by Location Medical Services Limited. The service opened in 1997. It is an independent ambulance service in Shepperton, Middlesex. They primarily serve the communities of south east England.

The provider has had a registered manager in post since the service registered with us in June 2011.

Their main service was medical cover on event sites and film productions. The provider also had a small medical centre at the registered location. This provided basic first aid for contracted staff who worked in the film studios opposite.

In England, the law makes event organisers responsible for ensuring safety is maintained at events. This meant that the event medical cover came under the remit of the Health and Safety Executive. Therefore, we do not regulate services providing medical cover at events. However, the transport of patients from an event to hospital is a regulated activity.

The provider had five ambulances to carry out the regulated activity. They also had rapid response cars which they used for non-regulated activity. Therefore, we did not inspect their rapid response cars.

Updated 26 March 2020

Location Medical Services is operated by Location Medical Services Limited. The service provides emergency and urgent care and transports patients from event sites to hospital emergency departments when necessary. The service also provides a paramedic home visiting service with a GP consortium.

We inspected this service using our comprehensive inspection methodology. We carried out this announced inspection on 19 December 2019. 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.

This is the first inspection to be rated. We rated it as Good overall.

• The service provided mandatory training in key skills to all staff and made sure everyone completed 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. Vehicles were deep cleaned and swabbed for the presence of microorganisms.

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

• 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 used systems and processes to safely prescribe, administer, record and store medicines.

• 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.

• The service provided care and treatment based on national guidance and evidence-based practice.

• Staff assessed patients’ food and drink requirements to meet their needs during a journey.

• Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief advice in a timely way.

• The service monitored and met agreed response times so that they could facilitate good outcomes for patients. They used the findings to make improvements.

• The service monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients.

• The service made sure staff were competent for their roles.

• All those responsible for delivering care worked together as a team to benefit patients. They supported each other to provide good care and communicated effectively with other agencies.

• Staff gave patients practical support and advice to lead healthier lives.

• Staff supported patients to make informed decisions about their care and treatment.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

• Staff provided emotional support to patients, families and carers to minimise their distress.

• Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.

• The service planned and provided care in a way that met the needs of local people and the communities served.

• The service was inclusive and took account of patients’ individual needs and preferences. The service made reasonable adjustments to help patients access services.

• People could access the service when they needed it, in line with national standards, and received the right care in a timely way.

• It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff, including those in partner organisations.

• Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for staff. They supported staff to develop their skills and take on more senior roles.

• The service had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services.

• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

• Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

• Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events. Staff contributed to decision-making to help avoid financial pressures compromising the quality of care.

• The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required.

• Leaders and staff actively and openly engaged with patients, staff, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.

Nigel Acheson

Deputy Chief Inspector of Hospitals (South and London), on behalf of the Chief Inspector of Hospitals.

Updated 26 March 2020

The main activity provided by this service was event medical cover. However, CQC do not currently regulate event medical cover. A small proportion of the service’s activity was the urgent transfer of patients from events sites to hospital. This activity is regulated by us.

We saw that the provider had made significant improvements since our last inspection. They had addressed all our concerns.

We saw several areas of outstanding practice. This included their ‘make ready’ stores. The provider employed dedicated staff to manage their stock and equipment. Their paramedic primary care home visiting service, and their paediatric and adult critical care transfer. They had also developed a proposal with an NHS trust for a sepsis pathway. This would ensure immediate treatment of sepsis when a paramedic was first in attendance.

Updated 2 February 2018

The main activity provided by this service was event medical cover. However, CQC does not currently have the power to regulate event medical cover. A small proportion of the service’s activity was the urgent transfer of patients from event sites to hospital. In the reporting period September 2016 to August 2017, the service undertook 108 emergency and urgent care patient journeys from event sites to hospitals. This activity is regulated by CQC.

We found areas the service provider needed to improve:

• The provider did not have assurances all staff carrying out regulated activity had appropriate and up-to-date mandatory training in key areas.

• The provider did not have assurances all staff carrying out regulated activity had a meaningful annual appraisal to provide ongoing assurances of their performance and competencies.

• The provider had not taken sufficient action to mitigate identified clinical risks to the service. Other than client satisfaction questionnaires, there were no systems in use to assess, monitor and improve the quality and safety of the services provided at the time of our inspection.

• At the time of our inspection, we saw evidence the provider had not maintained accurate, complete and contemporaneous records for all patients.

• We raised concerns with the provider about the cleanliness of one of the three vehicles we inspected, as well as two pieces of equipment. We also raised concerns around three out-of-date oxygen cylinders we identified. The provider took immediate action to rectify these issues, and provided written confirmation of this to CQC.

  However, we also identified the following areas of good practice:

• Staff spoke positively about the culture of the service and could approach the leadership team at any time if they wanted to raise a concern or needed support.

• The provider had systems to ensure vehicles were maintained to keep them roadworthy. We saw evidence of up-to-date tax, MOT, insurance and servicing for all vehicles used to carry out regulated activity.

• We saw evidence of effective pre-employment checks to assess the suitability of new staff. These included Disclosure and Barring Service (DBS) and reference checks, and evidence of professional registration.