Updated 3 August 2015
NSL Northampton is part of a NSL Limited, a nationwide provider of patient transport services.
We undertook a focussed inspection in response to information of concern that we had received about this service.
We inspected elements of four out of the five key questions including whether the service was safe, effective, responsive and well led.
Updated 3 August 2015
We carried out a focused inspection on 12 May 2015 to review the service’s arrangements for the safe transport of patients as we have received information of concern about this service. As this was a focused inspection, we did not inspect every key line of enquiry under the five key questions.
Are services safe at this service
Not all staff were enabled to complete incident report forms according to NSL policy and there was no process in place to ensure wider learning took place from incidents which had been reported. The staff we spoke with were not able to fully recognise safeguarding issues. We identified some safeguarding issues which had not been reported and appropriate immediate action was not always taken when safeguarding concerns were identified. Incidents which must be notified to the Care Quality Commission had not always been notified to us.
Arrangements for transporting patients who may have an infection were not adequate. We were told that reliance was placed on the discharging clinician to make decisions about whether a patient should travel without other patients on board.
Are services effective at this service
We identified concerns regarding the Do Not Attempt Resuscitation arrangements for the service. We asked NSL Northampton to take immediate action to address our concerns which they did promptly.
Are services caring at this service
This was a responsive inspection and we did not consider this as part of the inspection.
Are services responsive at this service
We were told that the policy for Ambulance Care Assistants to work in pairs for some patient journeys was followed.
Complaints were not always responded to in a timely manner, although lessons learned were recorded.
From the performance reports provided, we saw that a significant proportion of patients waited more than 90 minutes for collection after their appointment or discharge and some patients were late for their appointment.
Are services well led at this service
Suitable arrangements for staff to provide feedback about the service were not in place. Staff meetings were held but not accessible to all staff and staff were not paid for attendance at meetings. Team leader meetings were held and standard agenda items were discussed each week, although actions being taken was not always documented or owned.
We identified areas of poor practice where the provider needs to make improvements.
Importantly, the provider must take action to ensure compliance with regulations 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (the Regulated Activities Regulations 2014).
Updated 3 August 2015
We found that a significant proportion of patients were subject to a long wait for collection and it was unclear from the information provided whether staffing arrangements were adequate to meet demand.
Staff training was not adequate and procedures for supporting staff to raise concerns needed improvement.
Arrangements for reporting incidents and safeguarding concerns were not sufficiently robust to ensure all incidents were reported or acted on appropriately and regulatory requirements were not being met.
We found that vehicles were not always repaired or taken off road promptly.
Governance arrangements, including acting on concerns raised at meetings, were not sufficient and some policies and procedures needed updating.
Infection control arrangements failed to ensure patients were adequately protected.
Do Not Attempt Resuscitation arrangements were not robust; we asked the service to take immediate action which they duly did.