Archived: PREMIER MENTAL HEALTH PATIENT TRANSPORT LTD

Updated 1 December 2021

Premier Mental Health Patient Transport Limited (formally known as Premier Rescue Ambulance Service Limited) is operated by Premier Mental Health Patient Transport Limited. It provides a patient transport service to people living in Devon and Somerset and the surrounding areas. If required, the service reaches further out into the South West of England and further afield to provide patient transport services. The provider delivers non-emergency ambulance transport for adults with mental health conditions, most of whom are detained under the Mental Health Act 1983. It also provides transport for non-detained adult patients, for example patients who are voluntarily going into hospital for referral or treatment.

We inspected this service using our focused inspection methodology. We carried out the short notice announced inspection on 29 September 2021.

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? At this inspection, we concentrated on the issues within well-led as a follow-up to our previous inspections.

The provider is registered to provide the following regulated activity:

• Transport services, triage and medical advice provided remotely.

The registered manager had been in post since 2020. Registered managers have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

The provider had six members of staff. These included two care assistants, a driver and the three members of the management team. The fleet consisted of two vehicles and between 1 March 2020 and 30 March 2021, the service provided 989 patient journeys.

The provider had two days’ notice of our visit to ensure staff would be available to give us access to the site and records.

Updated 1 December 2021

Our rating of this location went down. We rated it as inadequate because:

There were no reliable systems to ensure staff were trained adequately for their roles to keep patients safe. There was very limited assurance staff had training in key skills, understood how to protect patients from abuse or managed safety well. The provider did not control infection risks well. Staff did not always assess risks to patients and the provider was not able to assure us staff were adequately trained to be able to safely monitor patient conditions. Staff did not keep good care records for patient monitoring of their physical or mental health conditions during transfer. There was a basic system for staff to identify, report, receive feedback or share learning about incidents and concerns but it was not accurate or embedded in the service. The recruitment process did not ensure safety checks about new staff were used to protect patients.

The provider did not monitor the effectiveness of the service or make sure staff were competent. The provider did not always meet and monitor agreed response times. The provider planned care to meet the needs of local people but did not take account of patients’ individual needs. It was not easy for people to give feedback.

Managers of the provider did not have the capability to run services well. Staff were not supported to develop their skills. Managers showed little understanding of the safety and business priorities and how to manage them. There were no reliable and consistent systems to provide oversight of safety and quality of care delivered. Managers were not clear about their legal responsibilities of providing care under the regulated activities. Managers tried to support staff but opportunities for staff development were limited. Managers wanted to provide a safe service and wanted to put the patient at the centre of their service planning but were not clear on how to achieve this. There was no consistent, embedded system for gathering and reviewing feedback, incident reports or reviewing risks. There were electronic processes for gathering patient views which limited opportunity to feedback and there was no evidence of how these were discussed or actioned. The provider had no vision and values to apply them in their work.

However:

Staff assessed patients’ food and drink requirements. People could usually access the service when they needed it.

Updated 18 June 2021

See the overall summary section above.