Archived: Invictus Medical Services Limited

Updated 9 April 2019

Invictus Medical Services Limited was operated by Invictus Medical Services Limited. It is an independent ambulance service in Ryde, Isle of Wight. The service primarily served the communities of the Isle of Wight.

The service was registered by the Care Quality Commission (CQC) in January 2018. Previously, it had only provided paramedic and first aid services to events, a service which is not regulated by CQC. The service was registered with CQC so it can convey patients from event sites to the local acute NHS hospital. Conveyance of patients outside event sites is regulated by CQC.

Invictus Medical Service Limited is not commissioned by other organisations to provide services. The service obtains work through tendering processes with event organisers. Although the provider told us they would deliver patient transport service if the opportunity arose. At the time of the inspection the only service delivered was emergency and urgent services. This was what we inspected and reported on.

The service has had a registered manager in post since registration with CQC on 26 January 2018. A registered manager is a person who has registered with CQC to manage a service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how a service is managed.

Following our findings at an inspection of this service on 27 November 2018, we served a decision to urgently suspend the registration of the provider until 11.59pm on 28 February 2019, because we believed that people were or may be exposed to the risk of harm if we did not take this action.

Updated 9 April 2019

Invictus Medical Services Limited is operated by Invictus Medical Services Limited. The service provides an emergency and urgent care ambulance service by conveying patients from event sites to the local acute NHS trust. Invictus Medical Services Limited was not commissioned by other organisations to deliver services. Work was acquired through tendering processes with event organisers. Although the provider told us they would provide patient transport services, if the opportunity arose, at the time of the inspection they were only delivering was emergency and urgent care services.

We inspected this service using our comprehensive inspection methodology. We gave the service two weeks’ notice of our inspection to ensure everyone we needed to speak with was available. We carried out the inspection on 27 November 2018. We had not carried out any inspections of the service previously.

The service had one emergency ambulance used to carry out the regulatory activities.

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 service understood and complied with the Mental Capacity Act 2005.

The service provided by this service was emergency and urgent care.

We found the following issues that the service needs to improve:

• The registered persons did not make sure all staff working for the service were of good character, had the qualifications, competence, skills and experience necessary for the work to be performed. They did not keep records about staff who worked for them.

• The registered persons did not make sure all equipment required to deliver safe care and treatment was available, in working order, in date and undamaged.

• There was no process to ensure all staff working for the service had completed appropriate mandatory training.

• The registered persons could not be assured about the quality of care and treatment staff gave to patients; there were no systems to supervise staff who worked for the service.

• The registered persons did not make sure that patients were not at risk from the risk of cross infection.

• The registered persons did not make sure patient records were fully completed.

• The registered persons did not make sure there was safe management of medicines that complied with national guidelines and legislation.

• There was no governance process to support systematic improvement of service quality and safeguarded high standards of care.

• There were no systems in place to identify risks, and to plan or to eliminate risks.

• The service did not have policies and procedures that were relevant to the service being delivered, or accurately detailed current legislation and national guidance.

• The registered persons did not consider national guidance to determine what level of children’s and young people’s safeguarding training that staff working for the service needed complete.

• The registered persons did not have processes in place to support staff to identify and respond to patient risks.

• The registered persons did not make sure that staff who worked for the service, where required, considered patients’ capacity to consent to care and treatment.

• The registered persons had not carried out the fit and proper persons process for all company directors.

• The directors and leaders of the service did not demonstrate a good understanding of their legal responsibilities towards the Health and Social Care Act.

• The registered persons did not ensure all staff who worked for the service had a good understanding about their responsibilities and obligation towards the Duty of Candour legislation.

However, we found the following areas of good practice:

• The service took account of national guidance and local legislation to ensure there were sufficient numbers of staff deployed for event work. This included ensuring there were sufficient staff to convey patients from the event to the local acute hospital.

• Staff had access to an online translation service.

• The service deployed on occasions staff, such as a learning disability nurses, to meet the needs of the patient groups.

Following this inspection, we told the service that it must take some actions to comply with the regulations.

The service was rated as inadequate overall. I am placing the service into special measures.

The service has also been subject to urgent enforcement action. Following this inspection we have used our enforcement powers to suspend the registration of  Invictus Medical Services Limited  to protect the safety and welfare of patients. The suspension will continue until 28 February 2019. Further details are shown in the table at the end of this report.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 30 January 2019

We have rated safe, effective and well led as inadequate. Responsive is rated as requires improvement. We have not rated Caring, as we were not able to inspect this key question because we did not observe any care.

There was no effective leadership of the service. There were no systems to identify and manage risks to the service, there were no systems to improve the service and ensure patients received high standards of care and records to support the running of the service were not kept. Lack of records meant there was no assurance that staff working for the service had the relevant qualifications, skills and capabilities to deliver safe care and treatment. There was no process to ensure essential lifesaving equipment was available and in working order. Policies and procedures were not relevant to the present service delivered, and in some policies the information was out of date and did not reflect current national and professional guidance.