Invictus Medical Services Ltd

Updated 19 March 2020

Invictus Medical Services Ltd is operated by Invictus Medical Services Limited. It is an independent ambulance service in Ryde, Isle of Wight, primarily serving the communities of the Isle of Wight. The service was registered by the Care Quality Commission (CQC) in January 2018 to provide transport services, triage and medical advice remotely and urgent and emergency treatment. Invictus Medical Service Ltd is not commissioned by other organisations to provide services. The service obtains work through tendering processes with event organisers.

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 2012 (Regulated Activities) Regulations 2014, and associated regulations about how a service is managed.

Following our findings at an inspection of this service on 27 November 2018, we rated the service as inadequate and urgently suspended the registration of the provider until 28 February 2019, because we believed that people were or might have been exposed to the risk of harm if we did not take this action. We carried out a focused follow up inspection of this service on 18 February 2019 to assess whether the provider had made enough improvements to meet regulatory standards. At that inspection we found that although some improvements had been made there were still concerns about some areas of the service.

We carried out a comprehensive inspection of this service on 1 July 2019, at which time we identified areas of concern and breaches of regulation. Following the inspection of 1 July 2019, Invictus Medical Services Ltd remained rated as inadequate.

Updated 19 March 2020

Invictus Medical Services Ltd 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 a tendering process with event organisers. Although the provider told us they would provide patient transport services if the opportunity arose, this activity was not being provided at the time of this inspection. We were not able to observe staff carrying out regulated activities as, at the time of the inspection, the service was not delivering any regulated activities. The service had one emergency ambulance to carry out the regulated activities.

The service did provide medical cover at events. However, the CQC does not currently have the power to regulate events work, therefore we did not review that work within this report.

We previously inspected the service on 27 November 2018, using our comprehensive inspection methodology. Due to the concerns we had about the lack of governance, the management of safety and staffing concerns, the service was rated inadequate and placed in special measures. We urgently suspended the registration of the provider because we believed that people were or might have been exposed to the risk of harm if we did not take this action.

We carried out a focused follow up inspection on 18 February 2019 to assess whether the provider had made enough changes to the service to lessen the risk to people using the service. Following this inspection, we told the provider of additional areas where it must take some action 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 Invictus Medical Services. This was not a full inspection and the rating and actions of the previous report remained active until we carried out a comprehensive inspection.

On 1 July 2019 we carried out an inspection using our comprehensive inspection methodology, following which the service remained rated as inadequate and remained in special measures.

On 17 January 2020 we carried out a focussed inspection of the service. At this inspection we assessed the provider’s progress against specific areas of concern and breaches of regulation that were identified at the inspection in July 2019. This was not a full inspection and the rating of inadequate remains until we carry out a comprehensive inspection.

We gave the service two weeks’ notice of our inspection to ensure everyone we needed to speak with was available. We spoke with two of the directors. The registered manager, who was the third director, was unavailable for this inspection. The service contracts self-employed staff when needed, they had not carried out any regulated activity since the last inspection and therefore no staff or patients were available to speak with.

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

We found the following areas of improved practice:

We found the provider had addressed the specific concerns raised at the inspection in July 2019. In particular:

• The safeguarding lead had completed level 3 training about both safeguarding children and young people and safeguarding adults.

• The provider had reviewed and revised safeguarding policies, which now included current national best practice guidance.

• The service followed processes to ensure all equipment on the ambulance was available, clean and in date.

• Equipment was serviced by professionals to ensure it was safe to use.

• The provider had purchased a child harness to enable children to be conveyed on the stretcher.

• The provider had reviewed and revised their medicines management policies to reflect the service provided and reference current legislation and best practice guidance.

• The provider had made some improvements to the governance of the service. They held monthly meetings which were recorded, there was now a planned programme for review and revision of policies and procedures.

• The provider had a risk management policy and manager meeting records detailed some of the actions the service was taking to lessen risks to the service and to people who used the service.

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

• The provider should consider changes and improvements to the governance and risk management of the service to demonstrate ongoing effective and safe leadership of the service.

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

Nigel Acheson

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

Updated 19 March 2020

This rating is from the previous comprehensive inspection. We did not re-rate this service as part of this focused inspection.

The provider had acted to address areas of concern and breaches of regulation identified at the previous inspection in July 2019. Processes were followed to ensure equipment on the vehicle was available, was in date, was clean and was safe to use. There was now a planned programme for review and revision of policies and procedures. Recent revisions to safeguarding policies and medicine management policies meant that they were relevant to the service and included reference to best practice guidance and relevant legislation. The provider had made some improvements to the governance of the service. The provider had made some improvements to the management of risks.

However, the provider should consider changes and improvements to the governance and risk management of the service to demonstrate ongoing effective and safe leadership of the service.