10 December 2019
During a routine inspection
Mariner Medical Services Limited is operated by Mariner Medical Services Limited. The service provides emergency and urgent care and a patient transport service (PTS). The service was previously called Mariner Medical and Driving Services; the name was changed in 2017.
The service provides first aid and medical cover at local events, which is not regulated by CQC; however, the transport of patients from events is also provided and this does fall within the scope of CQC registration. Due to there being only one patient transfer from an event in the year prior to our inspection, the focus of this report will be the PTS aspect of the business.
We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 10 December 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.
The main service provided by this service was patient transport. Where our findings on emergency and urgent care, for example management arrangements, also apply to other services, we do not repeat the information but cross-refer to the PTS section.
We have not previously rated this service. We rated it as Requires improvement overall.
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The service did not maintain a consistent record of staff training and competence.
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Risk assessments for patient transfers were not documented for either PTS or events’ journeys.
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We found the service did not have polices in place relating to management of the deteriorating patient, information governance or medicines’ management.
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We were not assured that managers and staff were familiar with policies.
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The service did not have processes in place to monitor effectiveness.
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Staff induction records were not retained, and appraisals were not documented.
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There was no established process in place for people to give feedback or raise concerns and the service did not have a policy in place for the management of complaints.
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The service did not have a documented vision or strategy.
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We were not assured governance of the service was robust.
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Pre-employment checks were not retained in staff records.
However:
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The service had enough staff to care for patients and keep them safe. Staff understood how to protect patients from abuse. The service controlled infection risk well.
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Staff ensured patients’ comfort and worked well together for the benefit of patients.
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Staff told us they treated patients with compassion and kindness, respected their privacy and dignity, and provided emotional support to patients, families and carers. Patients we spoke with confirmed this.
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Leaders were approachable. Staff felt respected, supported and valued, and were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.
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. We also issued the provider with four requirement notices that affected both core services. Details are at the end of the report.