All inspections: IMT Medical Transport Headquarters

IMT Medical Transport Headquarters is operated by IMT Medical Transport Limited. It is an independent ambulance service which was first registered in January 2018. The service is located in Liverpool and serves several NHS hospital trusts and local authorities. The service provides a patient transport service specialising in the transfer of mental health patients, including those detained under the Mental Health Act 1983, across the country.

We inspected this service using our inspection methodology. We carried out a focused unannounced visit to the service on 13 August 2020 and interviewed staff remotely on 4 September 2020 to follow up on enforcement action issued from the previous comprehensive inspection on 2 and 3 October 2019. We did not rate the service as this was a focused inspection.

Our previous inspection identified improvement was required as there was no effective systems in place to ensure risk assessments for patients were completed in line with policy and safeguarding concerns/referrals were made by operational staff. The policies did not identify all patient risks, the number of staff required for patient transport, how to manage a deteriorating patient, patient restraint, the Mental Health Act 1983 or the Mental Capacity Act 2005. Patient records were not completed to include all the necessary information, such as the, dynamic risk assessment on arrival, patient journey observations during transportation and the H4 authority form. (The H4 authority form is a legal document under the Mental Health Act 1983, to transfer a patient from one hospital to another under different managers).

We found the following issues that the service provider needs to improve:

The service had reviewed and amended policies, but not all the information was clear and detailed for staff to follow. The policies did not always include best practice guidance or legislation.
There was no clear process for regular audits of the service provided.
It was unclear who the clinical and mental health support for the service was.

However, we found the following areas of good practice:
The service had made improvements in relation to the safeguarding processes and procedures for referrals by operational staff. Support for the service safeguarding lead was in place until face to face training could be arranged due to external influences.
The service had made improvements to documentation and procedures to make sure incidents, including restraint were reported and investigated.
The service had identified exclusion criteria for patient transport
The service had made improvements to documentation to identify and record patient risk and assessments so the risks to the health and safety of the service users were assessed and risks were mitigated.

Following this inspection, we told the provider that it must take some actions to comply with the regulations. Details are at the end of the report.

Ann Ford

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

IMT Medical Transport Headquarters is operated by IMT Medical Transport Ltd . It is an independent ambulance service which was first registered in January 2018. The service is located in Liverpool and serves several NHS hospital trusts and local authorities. The service provides a patient transport service specialising in the transfer of mental health patients, including those detained under the Mental Health Act 1983, across the country.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 2 and 3 October 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.

We had not previously inspected this service. We rated it as Requires improvement overall.

We found the following issues that the service needs to improve:

Staff did not always have a clear understanding of how to protect patients from abuse or how to recognise and report it.
Risk assessments were not always comprehensive and were not updated for each patient.
Records were not detailed and did not reflect the patient’s journey or the care received accurately. Records were not always clear or available to staff and management.
Incidents, near misses and patient safety issues were not always managed well. Staff did not always recognise and report incidents and incidents were not always documented appropriately; in line with policy and best practice guidance.
Patient outcomes were not always measured or monitored and policies did not always follow best practice guidance or standards.
Leaders did not always operate effective governance processes or use systems to manage performance effectively.
Leaders did not always identify or escalate relevant risks and issues or identify actions to reduce their impact.
Leaders and teams could not always access and find the data they needed, data was not always collected and was not always available in accessible formats to allow staff to understand performance and drive improvement.

However, we found the following areas of good practice:

The service had enough staff with the right qualifications, skills, training and experience to provide the right care and treatment. The service had suitable premises and equipment and looked after them well.
Patients could access the service when they wanted to, and services were planned to meet the needs of the individual patients.
Managers promoted a positive culture that supported and valued staff. Staff were clear on their roles and responsibilities.

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, even though a regulation had not been breached, to help the service improve. We also took enforcement action telling the service that it had to make significant improvements. This is detailed at the end of the report.

IMT Medical Transport Headquarters

All Inspections

13 August and 4 September 2020

During an inspection looking at part of the service

2 to 3 October 2019

During a routine inspection

Professor Sir Mike Richards

Chief Inspector of Hospitals