Archived: Opelwood Limited Also known as North East Medical Services and OSR Medical Ambulance Service

Updated 3 July 2018

Opelwood Limited opened in 2015. It is registered with CQC as an independent ambulance service (trading as ‘North East Medical Services’), which primarily serves the communities of Humberside, Yorkshire, and the North East.

The ambulance service uses one ambulance, one ambulance car, and two bicycles to provide a first-aid and ambulance service for sporting, performance, and community events. There are some exemptions from regulation by CQC which relate to particular types of service. (These are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.) Event cover such as this falls under one of those areas of exemption. However, because its ambulance and ambulance car are occasionally used to transfer patients from an event to hospital, we class Opelwood Limited as a provider of urgent & emergency care, and so it is registered with CQC. The organisation is also registered to provide a patient transport service (PTS), but it is not currently undertaking this type of work; having carried out a few instances of PTS work early in its existence, it has since been unable to secure any further contracts. However, managers told us that they hope that, by expanding the business and fleet, they will be able to attract new PTS business soon.

Overall, the service is currently registered to provide the following regulated activities:

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

The service has had the same registered manager in post since the organisation opened in 2015. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations.

This was our first inspection of the service since its registration with CQC.

Updated 3 July 2018

Opelwood Limited, trading as North East Medical Services, is operated by Opelwood Limited. It is an independent ambulance service which provides emergency and urgent care in the form of transport from events to hospital. The organisation is also able to provide a patient transport service but is not currently undertaking such work at this location.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 22 March 2018.

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.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve, and we take regulatory action as necessary.

We found the following areas of good practice:

• The service had a system for recording and reporting incidents. Staff were aware of their roles and responsibilities in respect of reporting incidents, near misses, and concerns.
• Staff mandatory-training-compliance rates were high in all but one area, and the service provided regular updates and additional training, based on reflective assessment of needs.
• The service had policies and procedures to protect vulnerable adults and children. Staff knew how to report safeguarding concerns.
• There were systems to maintain the cleanliness of vehicles and equipment, and managers and staff were aware of good practice in infection prevention and control.
• Medicines were stored appropriately and there was a medicines policy, which outlined arrangements for their storage, administration, and disposal.
• Confidential patient records were completed clearly and stored securely.
• Staff were aware of their responsibilities to assess and respond to patient risk. They were trained in basic observations.
• Staffing levels and skill mixes for each event the service attended were planned to ensure that people were safe from avoidable harm and received safe care and treatment.
• The service’s policies and processes were largely based on national guidance and recommendations.
• The service’s induction process developed and supported staff through mandatory training and mentoring to ensure competency. Training and support were priorities within the service.
• Staff understood the need to seek patient consent and to assess capacity to agree to treatment.

• Staff also understood the need to ensure dignity in public places and for those in vulnerable circumstances and to treat patients and their families with compassion.
• The service had taken steps to enable it to work with patients with various complex needs, including learning disabilities and dementia, and with those whose first language was not English.
• Staff recognised the strategic aims of the company and were aware of management’s aspiration to expand its services.
• The service’s policies and procedures were all up-to-date and were easy for staff to access.
• Staff roles were made clear within the service’s recruitment policy and its medicines policy. All staff joining the service were subject to a Disclosure & Barring Service check and reference check.
• Staff were positive about the service’s culture and felt able to raise concerns with managers. Staff said that managers were approachable and supportive and that they responded to and acted upon staff feedback.

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

• Up-to-date fire-safety-training compliance was very low.
• There was no evidence that any of the service’s medical machinery had been calibrated.
• Managers were not able to provide us with evidence that the mechanic who serviced their medical equipment was competent to do so.
• Some stocks of oxygen and of nitrous oxide/oxygen mixture cylinders were stored next to empty cylinders, and the service did not keep spare cylinders of compressed oxygen in stock.
• The service did not have a written policy or protocol for dealing with disturbed or violent patients.
• The service’s business continuity plan did not set out what to do in the case of office fire/destruction, loss of premises/files/stores/vehicles, involvement of one of its vehicles in a road traffic accident, or any systems back-up.
• There were no specific protocols for assessing and treating patients with suspected heart attack or stroke.
• There were no specific protocols for assessing and treating potentially vulnerable adults, such as those with learning disabilities or mental health issues, or children.
• Managers could not tell us how many staff had had their annual appraisal interviews.
• The written complaints procedure produced by the service erroneously stated that CQC could help with a complaint and did not explain the role of the Parliamentary and Heath Service Ombudsman, nor how and when to contact the ombudsman.

Ellen Armistead

Deputy Chief Inspector of Hospitals  (North Region), on behalf of the Chief Inspector of Hospitals.