Archived: Beverley Ambulance Service Limited

Beverley Ambulance Service Limited is operated by the Beverley Ambulance Service Limited. The service provides a patient transport service for NHS and independent health providers.

Beverley Ambulance Service Limited was not commissioned or contracted to provide patient transport services for any commissioners, NHS or private health providers. Patient transport services were provided on an as required basis.

The service also provided private emergency first aid and medical cover at sporting venues and events, medical repatriations and transport on behalf of insurance companies as well as organ transport. These activities were not regulated by the care quality commission and were therefore not inspected.

We carried out an unannounced inspection of the service using our comprehensive inspection methodology on 8 October 2019.

Following that inspection significant concerns were identified in relation to regulatory compliance. A notice under Section 31 of the Health and Social Care Act 2008 was issued to the provider suspending registration as a service provider in respect of patient transport services from 11 October 2019 until 25 November 2019.

We carried out an unannounced responsive follow up inspection of the service on 21 November 2019 focussing on the issues highlighted in the Section 31 notice.

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 decision to update ratings following a focused inspection is dependent on us having sufficient evidence to update the existing rating. It was decided there was not sufficient evidence to update the existing ratings or rate the core services in this inspection report.

Following this inspection, we told the provider that it should take one action to comply with the regulations to help the service improve. Details are at the end of the report.

We did not rate this service following this inspection.

Ann Ford

Deputy Chief Inspector of Hospitals (North East), on behalf of the Chief Inspector of Hospitals

Beverley Ambulance Service Limited is operated by the Beverley Ambulance Service Limited . The service provides a patient transport service for NHS and independent health providers.

Beverley Ambulance Service Limited is not commissioned or contracted to provide patient transport services for any commissioners, NHS or private health providers. Patient transport services are provided on an as required basis.

The service also provides private emergency first aid and medical cover at sporting venues and events, medical repatriations and transport on behalf of insurance companies as well as organ transport. These activities are not regulated by the care quality commission and were therefore not inspected.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the service on 8 October 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.

Our rating of the service was Inadequate overall.

• The provider did not have a structured approach to identifying the training needs of staff or have a monitoring system to ensure staff received mandatory and statutory training.
• The provider did not record the qualifications held by staff to show they were suitably trained for their role.
• There was no policy, process or procedure for staff to follow to seek advice from the clinical lead.
• There was no policy or process for staff to follow in relation to dealing with deteriorating patients.
• There was no policy or process for staff to follow as to what action to take if a patient they were transporting had a do not attempt cardio pulmonary resuscitation (DNACPR) order in place.
• The provider did not follow the follow the British institute of cleaning science and national patient safety (2016) colour coding systems for identifying which cleaners to use on which areas of the vehicles or premises.
• There were no facilities at the providers operating base for the disposal of clinical waste.
• The provider did not store medical gasses in accordance with the health and safety executive regulations 1998.
• The provider did not have a supply of consumable items to replace those used on the ambulances.
• There was no transport eligibility criteria of patients’ policy to ensure the service was not transporting patients whose medical conditions were such that the staff transporting the patient were not suitably qualified or experienced to transport such patients.
• The provider did not use patient record forms during the booking in process, taking responsibility for the patient, during the patient transport and during the patient handover procedures.
• Staff records were incomplete.
• There was no incident reporting policy, duty of candour policy or safeguarding policy.
• The providers management team and directors did not have a clear understanding of the Health and Social Care Act regulations 2008 (Regulated Activities) Regulations 2014 (Part 3), how they applied to their business and how to comply with them.
• The provider did not have any key performance indicators to measure the quality and safety of the services provided.
• There was no set programme of audits carried out or a process whereby the audit results could be reviewed, and any resultant improvement actions taken.
• There was no risk register.
• There was no induction course for new staff or a training needs analysis carried out.
• There was no record of staff health clearance checks and proof of identity or eligibility to work in the UK.

Following this inspection significant concerns were identified in relation to regulatory compliance. A notice under Section 31 of the Health and Social Care Act 2008 was issued to the provider suspending registration as a service provider in respect of patient transport services from 11 October 2019 until 25 November 2019.

We told the provider that it must take 47 actions to comply with the regulations to help the service improve. We issued the provider with one requirement notice and four enforcement notices that affected patient transport services. Details are at the end of the report.

Name of signatory

Sarah Dronsfield

Deputy Chief Inspector of Hospitals (North East), on behalf of the Chief Inspector of Hospitals