Archived: Secure Care UK Headquarters

Updated 3 March 2020

Secure Care UK Headquarters is operated by Secure Care UK Limited. The service opened in 2013 as a sole trader. This was changed to a limited company in December 2018. It is an independent ambulance service and has one location registered with the CQC in Hastings in East Sussex. The service also provided satellites in Birmingham, Leeds, Lincoln and Hampshire.

There was no registered manager at the time of the inspection. The provider had submitted an application to us to register a new registered manager. This application was processed on 29 November 2019. The provider confirmed that the new registered manager would be based at the organisations’ headquarters.

The service provided patient transport for three NHS foundation trusts and two clinical commissioning groups across England. On average, the provider completed 432 patient journeys a month.

The type of transport provided included: transfers from secure mental health services to prisons or courts; transfers from mental health inpatient units to general acute settings for medical care; transport from patients’ home address to a mental inpatient setting and transfers for patients using community mental health services and learning disability services. The service also provided one to one observations of patients on mental health wards and monitored patients at section 136 suites. A section 136 suite is a dedicated unit for patients waiting for a mental health assessment.

We have previously carried out three inspections of the service. This included an unannounced inspection of the service on 2 April 2019 followed by a short announced visit to the service on 3 April 2019. Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached. This was to help the service improve. We also issued the provider with two requirement notices, where fundamental standards had not been met in relation to its patient transport services.

Updated 3 March 2020

Secure Care UK Headquarters is operated by Secure Care UK Limited. The service provides a patient transport service for adults and children with mental health disorders. They also observe people in section 136 suites while they are awaiting a mental health assessment. A 136 suite is a place of safety for people who have been detained under Section 136 of the Mental Health Act 1983, due to concerns about their mental wellbeing and safety.

We carried out an unannounced inspection of Secure Care UK Headquarters on 25 November 2019. This was in response to information of concern. We considered the findings of our previous inspection on 2 April and 3 April 2019, when this information was relevant to the concerns raised, or our findings from this inspection. Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

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.

We focused our inspection on the questions of safe and well led because this is what the information of concern related to.

To see the most up-to-date rating for the questions of effective and responsive, please see the inspection report published on 26 June 2019. The question of caring has not previously been rated due to insufficient evidence to be able to rate this question.

The service is rated Requires Improvement overall.

Our rating of this service stayed the same. We rated it as Requires improvement overall.

• The provider did not have effective pre-employment checks to assess the suitability of new staff. They did not always use reference checks to determine if new employees were suitable to employ.

• Although the provider had implemented a coordinated programme for reviewing all polices, practice did not always reflect their policy related to recruitment checks.

• The provider considered the duty of candour when reviewing complaints. The current process for reviewing incidents, did not routinely consider if the duty of candour applied.

• The provider did not ensure all staff had a meaningful annual appraisal.

However:

• The provider had strong leadership. They were visible, proactive and engaged with staff.

• Staff spoke positively about the culture of the service. They felt valued, listened to, and able to raise concerns as well as ideas.

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm, and to provide the right care and treatment.

• The provider had improved its training compliance since the inspection in April 2019. As a group of staff, training compliance had exceeded 80% in all modules apart from the practical element of moving and handling. All staff attended annual training updates.

• The shift patterns had been reviewed and changed to ensure all staff had a minimum break of 11 hours between consecutive shifts. This was largely in response to staff feedback.

• The provider controlled infection prevention well. They had recently established a contract with an external cleaning company to complete deep cleans. This included all their vehicles used for regulated activity.

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

• The provider had introduced patient care records. We saw they were recording more detailed information of patients’ care than when we inspected in April 2019. However, records were not always stored securely.

• The provider had introduced a process for coordinating the review of all incidents and disseminating learning to staff that were involved. While this learning had not been shared with all staff, the provider had plans to share the learning across the service.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected patient transport services. Details are at the end of the report.

Name of signatory

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

Updated 3 March 2020

Secure Care UK specialised in the transport of adults, children and young people with ill mental health. They also supervised patients in section 136 suites when they were waiting for a mental health assessment. The service ran from a single location based in Sussex but had four additional sites across England.

Although there was evidence that the service had made changes since the last inspection, we found pre-employment checks to assess the suitability of staff were not always effective.

There was evidence the duty of candour was applied as part of the complaints process. We could not find evidence that it was considered following incidents.