Medi 4 Southern Regional Headquarters

Updated 23 March 2021

Medi 4 Southern Regional Headquarters is operated by Medi 4 Ambulance Services Ltd. The service opened in 2016. It is an independent ambulance service in Crawley, Sussex. The service primarily serves the communities of Sussex and the Isle of Wight.

The service has had a registered manager in post since 2016.

The team that inspected the service comprised of a CQC inspection manager, three CQC inspectors, and a specialist advisor with expertise in patient transport services. The inspection team was overseen by Catherine Campbell, Head of Hospital Inspection.

The service is registered to provide the following regulated activities:

• Transport services, triage and medical advice provided remotely
• Treatment of disease, disorder or injury

During the inspection, we visited the service headquarters. We spoke with eight staff including; emergency ambulance technicians, patient transport drivers, administrators, support staff and management.

There were no special reviews or investigations of the service ongoing by the CQC at any time during the 12 months before this inspection. The service has been inspected twice, and the most recent inspection took place in October 2019. The last inspection rated Medi 4 Ambulance Services Ltd as good overall.

Activity (January 2020 to November 2020)

• In the reporting period January 2020 to November 2020 there were 3751 emergency and urgent care patient journeys undertaken.
• In the reporting period January 2020 to November 2020 there were 28773 patient transport journeys undertaken.

The service employed 114 ambulance care assistants and 43 emergency ambulance technicians; the service also had a bank of temporary staff that it could use. The accountable officer for controlled drugs (CDs) was the registered manager, who was a registered paramedic.

Track record on safety

• Zero Never events
• Clinical incidents 25, 11 risk not assessed, 10 low harm, 4 moderate harm, zero severe harm, zero deaths
• 1 serious injury (staff member - independent investigation concluded no fault with the provider)
• 10 complaints

The main service provided was patient transport although the provider also did emergency ambulance shifts for two NHS ambulance trusts.

Updated 23 March 2021

Medi 4 Southern Regional Headquarters is operated by Medi 4 Ambulance Services Ltd. The service provides emergency and urgent care and a patient transport service.

We inspected this service using our focused inspection methodology. After the Care Quality Commission received information of concern about the provider we carried out an unannounced inspection on 15 December 2020.

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? During this focused inspection we looked at the domains of Safe 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 service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff kept good care records. The service managed safety incidents well and learned lessons from them.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However,

• The provider was unable to provide assurance the wastewater was entering the correct drainage system and the appropriate agencies aware.
• A few staff were unaware of the correct procedures for soiled linen disposal and sharps disposals in the ambulances we viewed.
• The service did not have a formal policy for the inclusion or exclusion patient acceptance criterion when accepting patient transport journeys.
• The provider was unable to provide assurance that service level agreements in place with other organisations was enough to meet the needs of the service, with a focus on risk assessments and an acceptance criterion.
• The provider was unable to provide assurance their patient group directions met legal requirements.
• The equipment storage room was disorganised, and it was not always possible to differentiate between equipment that was in use and equipment that was awaiting repair or service.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Nigel Acheson

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

Updated 23 March 2021