Archived: Southern Country Ambulance Service

Updated 6 November 2019

Southern Country Ambulance Service was operated by Mr. James Ball. It was a family run, independent ambulance service in Basingstoke, Hampshire. The service opened in 2003. The service primarily served communities in the South of England. The service had had a registered manager in post since 2003.

The service had three vehicles equipped to carry out outpatient transfers, hospital discharges, repatriation work, admissions and urgent transfers. At the time of our inspection, one vehicle was having repair work completed due to a road traffic incident and the service had been using a hire vehicle for the last two months.

The registered manager and provider of Southern Country Ambulance Service had previously been trained as an emergency medical technician. There were four members of staff who were self employed and contracted to work for the service. This included two full-time crew members, one paramedic contracted on a casual basis when needed and a part-time administrator. All the staff members apart from the paramedic were family members.

We inspected this location in November 2016 and issued two requirement notices and told the provider they must take action to address concerns in five areas. On this inspection, we found that the provider had not made improvements in all the areas we highlighted in 2016.

We inspected this service using our comprehensive inspection methodology. We gave the service 24 hours’ notice of our inspection to ensure everyone we needed to speak with was available. We carried out the inspection on 25 July 2019.

Following this inspection, the provider stopped providing regulated activities and cancelled their registration with the CQC. The provider is no longer registered with CQC.

Updated 6 November 2019

Southern Country Ambulance Service is operated by Mr. James Ball. The service provides a patient transport service to privately funded and NHS patients.

We inspected this service using our comprehensive inspection methodology. We gave the service 24 hours notice of our inspection to ensure everyone we needed to speak with was available. We carried out the inspection on 25 July 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 services.

We rated the service as inadequate because:

• The registered manager did not ensure staff had the right skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. Staff did not receive formal appraisals or supervision.

• Not all staff held safeguarding training on how to recognise and report abuse and had not received training specific for their role.

• The service did not manage patient safety incidents well. Staff did not recognise all incidents and near misses and therefore did not always report them.

• The service did not monitor the risk of infection to patients. There was no oversight of cleaning procedures and staff had not received infection prevention and control training.

• The service did not have a formal system or process to safely prescribe or administer medical gases.

• There were no formalised systems or processes to monitor and improve the quality and safety of the service.

• There were no systems to monitor performance or identify and plan to eliminate or reduce risks.

• Staff did not follow procedures to assess and respond to patient risk.

• The service did not collect or analyse information to contribute to the performance and sustainability of the service.

• The registered manager of the service did not demonstrate they had all the necessary skills and knowledge to effectively manage and develop a registered service with CQC.

• The service could not provide assurance that care and treatment was evidence-based. The service did not monitor the effectiveness of the service.

• The service did not ensure staff understood their roles and responsibilities under the Mental Capacity Act (2005).

• The service did not use complaints and feedback from patients to improve the service.

• There were no effective processes to engage with staff and stakeholders.

• There was no evidence of innovation or significant improvement in the service.

However, we did find the following areas of good practice:

• Staff treated patients with compassion and kindness, respected their privacy and dignity and took account of their individual needs. They provided emotional support to patients, families and carers.

• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in their daily work. The registered manager was visible and approachable for all staff and staff could raise concerns without fear.

• The service had a vision for the care it wanted to deliver, and staff worked together to deliver it. The service planned care to meet the needs of local people and took account of patients’ individual needs. People could access the service when they needed it and did not have to wait too long for treatment.

• Staff kept records of patients’ care and treatment. Records were clear, stored securely and easily available to all staff providing care.

• Staff knew how to make a safeguarding referral and who to inform if they had concerns.

• The design, maintenance and use of facilities, premises, vehicles and equipment kept people safe. The service stored and recorded the use of medical gases safely. Confidential information was stored and disposed of securely.

• Staff assessed patients’ food and drink requirements to meet their needs during a journey.

Following this inspection, the provider stopped providing regulated activities and cancelled their registration with the CQC. Therefore, CQC no longer has the power to tell the provider that it must take any actions to address the issues outlined in the report or to issue requirement notices which would be issued to a registered provider. The enforcement section at the conclusion of this report only refers to actions taken prior to the provider's deregistration.

Nigel Acheson

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals

Updated 6 November 2019

Patient transport services were the only regulated activity provided by the service.

We have rated safe, effective and well-led as inadequate, responsive as requires improvement and caring as good.

Overall, we rated the service as inadequate because there was not effective leadership and governance of the service to ensure patients were safe from harm. There were no systems to identify and manage risks to patients or the business and no systems to monitor or improve the service. There was no assurance that staff had the relevant skills, qualifications and capabilities to deliver safe care and treatment.