14 September 2020
During an inspection looking at part of the service
The Limes Training Centre is operated by Nigel Owen Singleton. The service mainly provides care and treatment within the confines of public event site cover which is not a regulated activity. However, the provider does occasionally transport patients off site to other local healthcare providers and as such requires registration with the Care Quality Commission. This regulated activity is reported under emergency and urgent care services.
Conversations with the provider through our Emergency Support Framework led to serious concerns that the improvements required following the previous inspection had not been implemented. This, together with other issues that came to light through this engagement, led to a decision to inspect.
We inspected this service using our focused inspection methodology and we looked at whether the service was safe, effective and well-led. We carried out the announced part of the inspection on 14 September 2020.
Following the inspection, we wrote a Letter of Intent to the provider informing them that we were considering urgent enforcement action under Section 31 of the Health and Social Care Act 2008. However, the provider applied for, and was granted, deregistration meaning we were not able to take this, nor any other enforcement action.
We do not rate a provider as part of a focused inspection unless we take enforcement action. Enforcement action results in the limiting of ratings to a certain level and can result in them going down. Because we did not take any enforcement action there was no change to the ratings.
- The provider did not ensure all staff completed mandatory training including safeguarding. The safeguarding systems and processes within the service did not reflect up to date legislation and guidance. Recruitment practice within the service did not consistently meet the provider’s policy nor the requirements of the regulations. Safety critical medical devices were not maintained to the manufacturer’s recommendations and there were no systems to act on device alerts.
- The service did not make sure staff were competent for their roles. Managers only appraised some staff’s work performance.
- The provider did not operate effective governance processes throughout the service. We did not see effective structures, processes and systems of accountability to support the delivery of good quality services. The service did not have any systems and processes to manage risks and performance issues.
However
- The ambulances and stores were visibly clean, tidy and well stocked.
Following feedback immediately after the inspection the provider chose to no longer provide regulated activities within the scope of registration and made an application to cancel their registration which was granted. As at the time of publication of this report, the provider is no longer registered, CQC cannot make requirements of the provider that they must or should take actions to comply with the regulations.