Archived: Thruxton Industrial Estate

Updated 19 March 2019

Black Hangar is operated by Out of Hours Medics Ltd. The service opened in 2013 providing event medical service and training which is not regulated by CQC. The service registered with CQC in March 2018 to provide patient transport services. It is an independent ambulance service in Alton, Hampshire. The service primarily serves the communities of Hampshire, Dorset and Somerset.

The service has had a registered manager in post since March 2018.

The service provides pre-planned patient transport services for all age groups for private organisations and for some NHS Trusts. The service does not provide high dependency transfers or transport patients detained under the Mental Health Act.

The service also provides medical cover for some events including a small amount of conveyance. The registered manager estimated that the service had conveyed 10 patients since March 2018.

The service consisted of nine vehicles which included ambulances, rapid response cars, an operations truck and 4x4 vehicles. However, only two ambulances were used for patient transport journeys.

The service was led by a registered manager who had a background as an ambulance technician. A fleet manager was also employed to oversee the maintenance of vehicles. The service sub contracted the services of an accountant, medical director and independent clinical consultant. The service directly employed six members of staff for patient’s transport journeys and an office manager at the time of our inspection.

The service operated seven days a week, 24 hours a day. Patient transport journeys were carried out on weekdays and event medical cover was carried out at weekends. The service undertook patient transport journeys that were sub contracted to them by another independent ambulance service and did not hold any direct NHS contracts.

We inspected the patient transport service as part of our comprehensive methodology. We carried out a short notice announced inspection on 24 October 2018, giving the service less than 24 hours’ notice of our inspection. We did not inspect event paramedic provision care provided by this service as event paramedic provision services are exempt from our regulation.

Updated 19 March 2019

Black Hangar is operated by Out of Hours Medics Ltd. The service provides event cover and patient transport services. Black Hangar was not commissioned by NHS organisations to deliver services, but was sub-contracted to carry out patient transfer work by a company that was commissioned by NHS organisations. The general public were also able to book patient transfers, although at the time of the inspection there were no examples where this had been the case.

We inspected the patient transfer service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 24 October 2018. We had not carried out any inspections of the service previously.

The service had two emergency ambulance vehicles available for patient transfers.

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 found the following issues that the service needs to improve:

• There was no process or evidence that staff working for the service had completed mandatory training and updates required for their roles.
• Staff had not completed the required levels of safeguarding training for adults and children.
• There were no cleaning records of the ambulance completed and we found evidence of blood contaminated equipment.
• Hand hygiene and infection prevention audits were not completed.
• Emergency equipment was not ready for use, despite having a green tag that meant it had been checked and prepared.
• Vehicle checks were not recorded and there was no assurance that staff completed vehicle checks before patient transport journeys.
• Full and empty medical gas cylinders were stored together with no clear separation.
• The service did not make sure staff were competent for their role.
• The service did not have systems to supervise staff who worked for the service to give assurance about the quality of care staff delivered to patients.
• The service did not audit staff compliance with national guidelines in the delivery of care and treatment.
• The registered manager did not have the necessary range of skills, knowledge and experience to effectively manage and develop the service.
• There were no recorded governance meetings.
• There was limited evidence of clear vision and strategy to develop the service.
• The process for managing risks was not effective. Risks were not correctly identified and the registered manager was not aware of the serious risks we identified during the inspection.
• There was an absence of audits and there were no processes for the service to gain assurance of the delivery of high quality care.
• Staff development was not given sufficient priority and appraisals did not take place.
• There was some flexibility to take account of individual needs as they arose but the service did not meet the needs of all the people who used it. For example, staff did not have access to a translation service

However, we found the following areas of good practice:

• Policies we reviewed were in date.

Following this inspection, we told the service that it must take some actions to comply with the regulations.

The service was rated as inadequate overall and was urgently suspended.

Following this inspection we have used our enforcement powers to suspend the registration of Out of Hours Medics Ltd provider from 29 October 2018 to protect the safety and welfare of patients. The suspension will continue until 21 January 2019. We revisited this location on the 31 January 2019 and found that the service was no longer operating from this address.

Further details are shown in the table at the end of this report

Nigel Acheson,

Deputy Chief Inspector of Hospitals (London and South Central), on behalf of the Chief Inspector of Hospitals

Updated 19 March 2019

We have rated safe, effective, responsive and well led as inadequate. We have not rated Caring, as we were not able to inspect this key question because we did not observe any care.

There was no effective leadership of the service. There were no systems to identify and manage risks to the service, there were no systems to improve the service and ensure patients received high standards of care. There was no assurance that staff working for the service had the relevant qualifications, skills and capabilities to deliver safe care and treatment. There were no staff appraisals or governance meetings. There was no process to ensure essential lifesaving equipment was correctly checked and tagged. The service did not carry out audits to monitor the effectiveness of service delivery.