Archived: Jigsaw House Cheshire

Updated 15 July 2021

Jigsaw House and Lincolnshire Resource Base is operated by CRG Clinical Services Ltd and Jigsaw Medical. Jigsaw Medical is an independent provider of ambulance Services with a head office in Chester and satellite bases in Lincolnshire, Buckinghamshire and Basingstoke. They provide emergency and urgent care and patient transport services. They provide services for the communities in Lincolnshire, Essex and Cambridgeshire, Buckinghamshire, Oxfordshire, Berkshire and Hampshire.

Jigsaw Medical has a registered manager who has been in post since 2018. The service was inspected in 2019 and the report was published on 19 July 2019. The service was not rated at the time of the inspection. The concerns at the 2019 inspection were management of controlled drugs, clinical waste and the safety of vehicles. A requirement notice was issued as a result of this inspection.

The regulated activities are:

• Transport services, triage and medical advice provided remotely
• Treatment of disease disorder and injury

The main service provided at the Lincolnshire Resource Base in Heckington is emergency and urgent care which was the focus of this inspection.

Updated 15 July 2021

We did not rate this service at this inspection.

• Equipment checks were not always fully completed effectively as we found a number of out of date items.
• There was a lack of complete recording of patient early warning scores on patient records we reviewed.
• Not all aspects of the patient records were being audited to provide effective monitoring of all aspects of patient outcomes.
• The organisation did not always have clear governance structures in place to ensure oversight of services. We found that when audits had been completed there was no evidence of any action plans to improve standards of care when required. We also found that there were no actions or follow up to actions recorded following meetings where standards of care were discussed and improvements were required.
• Whilst the service had a clinical strategy in place, at the time of the inspection there was no evidence of an action plan to support the implementation of the strategy or any evidence of monitoring the strategy on a regular basis.
• There was a lack of assurance that performance was being monitored effectively as there was no service specific contract in place between the service and their commissioners to clearly outline performance measures for the service provided.

However,

• All staff were up to date with face-to-face mandatory training in key topics to ensure they could provide safe care to patients.
• The service controlled infection risk well. Documentation was in place for assurance about completion of cleaning and infection prevention and control of vehicles. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment, and premises visibly clean.
• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. They managed medicines well. Safety incidents were managed well and learned lessons from them.
• Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. All staff were committed to continually improving services.

Updated 15 July 2021

We did not rate this service at this inspection.

• Equipment/consumable checks were not always fully completed effectively as we found a number of out of date items.
• There was a lack of complete recording of patient early warning scores on a number of patient records we reviewed.
• Not all aspects of the patient records were being audited to provide effective monitoring of all aspects of patient outcomes.
• The organisation did not always have clear governance structures in place to ensure oversight of services. We found that when audits had been completed there was no evidence of any action plans to improve standards of care when required. We also found that there were no actions or follow up to actions recorded following meetings where standards of care were discussed and improvements were required.
• Whilst the service had a clinical strategy in place, at the time of the inspection there was no evidence of an action plan to support the implementation of the strategy or any evidence of monitoring the strategy on a regular basis.
• There was a lack of assurance that performance was being monitored effectively as there was no service specific contract in place between the service and their commissioners to clearly outline performance measures for the service provided.

However,

• All staff were up to date with face-to-face mandatory training in key topics to ensure they could provide safe care to patients.
• The service controlled infection risk well. Documentation was in place for assurance about completion of cleaning and infection prevention and control of vehicles. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment, and premises visibly clean.
• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. They managed medicines well. Safety incidents were managed well and learned lessons from them.
• Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. All staff were committed to continually improving services.