Kings Medical Services

Updated 24 February 2020

Kings Medical Services is operated by Mr David Chown. The service was registered on 22 April 2016. It is an independent ambulance service in Uttoxeter, Staffordshire. The service primarily served the communities of the Midlands.

The service has had a registered manager in post since it was registered.

The service provided pre-planned patient transport services, for all age groups from birth. Journeys included discharges from hospitals, transfers for specialist treatment, transport to and between care homes and repatriation of patients from within the UK and Europe.

The service had two ambulances. Both vehicles were equipped to carry out outpatient transfers, hospital discharges, repatriation work, admissions and urgent transfers.

The service also provided medical cover for some events. The CQC does not have the power to regulate this service

We inspected this location in November 2017 and issued four requirement notices. We told the provider they must take action to address concerns in thirteen areas. We found that;

• The provider must ensure medicines are only carried and administered by staff with the legal right to do so.

• The provider must review their policies on medicines and medicine administration to ensure they refer to and comply with current legislation.

• The provider must review their medicine guidelines to ensure they include correct and complete information on indications, administration routes, contra-indications and cautions, or direct staff to appropriate guidelines for this information.

• The provider must ensure they have a means of ensuring the temperature in their medicines storage cabinet has not been outside the medicines’ manufacturers’ guidelines for safe storage.

• The provider must ensure their electrocardiograph machines, defibrillators and medical gas pipelines are serviced and calibrated in accordance with the manufacturers’ recommendations and national guidelines.

• The provider must ensure their safeguarding policies are effective and refer to current guidelines and legislation and differentiate between adults at risk and children.

• The provider must complete training at an appropriate level in safeguarding adults at risk, and children and make arrangements to have access to a professional trained to level 4 safeguarding children.

• The provider must ensure all of the staff they employ on ambulance crews, whether substantive or bank staff, have completed safeguarding adults at risk training and safeguarding children level 2 training.

• The provider must also ensure they have documentary evidence on file that this training has been completed.

• The provider must ensure they have an effective incident reporting policy and procedure, and that staff are encouraged to report appropriate incidents.

• The provider must also have a process for monitoring incidents to identify trends and improve the quality and safety of the service they provide.

• The provider must keep accurate and up-to-date records of all training they provide for their staff, and for any statutory and mandatory training provided by their substantive employers.

• The provider must have a robust recruitment procedure that ensures staff have the right skills and experience to perform the tasks they have been employed to carry out.

On this inspection we found the provider had made significant improvements in all areas of concern. The service had made all changes which were highlighted during the previous inspection.

We inspected this service using our comprehensive inspection methodology. We gave the service 48 hours’ notice of our inspection to ensure everyone we needed to speak with was available. We carried out the inspection on 20 January 2020.

Updated 24 February 2020

Kings Medical Services is operated by Mr David Chown. The service provides emergency and urgent care and a patient transport service.

We inspected this service using our comprehensive inspection methodology. We gave the service 48 hours’ notice of our inspection to ensure everyone we needed to speak with was available. We carried out the inspection on 20 January 2020.

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.

The main service provided by this service was emergency and urgent care transport provided at events, the service also provided private patient transport services. On this inspection we inspected both core services.

Where our findings on patient transport services – for example, management arrangements – also apply to other services, we do not repeat the information but refer the reader to the patient transport core service.

We rated it as Good overall.

We found the following areas of good practice:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well.

• Staff provided good care and treatment and gave them pain relief when they needed it. Managers monitored the effectiveness of the service. Staff worked well together for the benefit of patients and had access to good information.

• Staff treated patients with compassion and kindness. Staff respected their privacy and dignity.

• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.

• Leaders ran services well using reliable information systems. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged with patients and staff.

However, we found the following issues that the service provider needs to improve:

• There were products on the vehicle which were past their expiry date.

• Managers did not formally appraise staff’s work performance.

• Leaders did not always use systems to identify and escalate relevant risks and issues and identify actions to reduce their impact.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 24 February 2020

Patient transport services were a regulated activity provided by the service. The same staff group provided all services including patient transport, urgent and emergency services and events activity.

We have rated safe, responsive and well-led as good. As we were unable to speak to patients on this inspection we were unable to rate caring. However, we were able to see from patient feedback cards and compliments evidence that staff were caring and compassionate.

Overall, we rated the service as good because the service was responsive in addressing the concerns raised at the last inspection. They complied with all warning and requirement notices. The service kept people safe and provided effective care that met people’s needs.

Updated 24 February 2020

The service provided urgent and emergency care at events which is not currently in our scope of regulation. However, the service conveyed a small number of patients to hospital services when required. This meant the service met the criteria for the emergency and urgent care core service. The service did not carry out any emergency ambulance work, for example, responding to 999 calls.

We have rated safe, responsive and well-led as good. As we were unable to speak to patients on this inspection we were unable to rate caring. However, we were able to see from patient feedback cards and compliments evidence that staff were caring and compassionate.

Urgent and emergency services were a regulated activity provided by the service. The main service was patient transport services. Where arrangements were the same, we have reported findings in the patient transport service section.