We carried out a focused unannounced inspection on 09 September 2015, to review Omni Healthcare’s arrangements for the safe transport and treatment of patients, because we had received information of concern about this service.
The Care Quality Commission had received information, from several different sources, which stated that Disclosure and Barring Service (DBS) checks had not been routinely carried out on employees and that some staff were working without these checks in place.
As this was a focused inspection, we did not inspect every key line of enquiry under the five key questions.
Are services safe at this service
There were serious concerns that care and treatment was not being provided in a safe way for patients.
We found inadequate recruitment processes in place which did not ensure all staff were of good character and had the required competence to carry out their roles.
We found inadequate arrangements for safeguarding vulnerable adults and children, with a lack of safeguarding training to ensure staff were aware of their responsibilities.
There was a lack of effective risk assessments being carried out, including fire safety to ensure the safety of patients and staff.
We found inadequate security arrangements for equipment and vehicles. We found vehicles open and unlocked and that equipment, including defibrillators, oxygen cylinders and, airways equipment and first aid were all accessible and at risk of being tampered with.
There was a risk of harm to patient safety due to insufficient equipment maintenance. We found a number of items of equipment throughout the service where the servicing had lapsed. We found equipment that had not been calibrated to ensure its safe and accurate use.
We found inadequate governance processes in place which did not monitor and assess the quality of service provided in carrying on the regulated activities.
Are services effective at this service
There were no systems in place to ensure staff were suitably appraised or received clinical supervision.
There was no evidence of an induction policy or process was being used within the service.
Are services caring at this service
This was a responsive inspection and we did not consider this as part of the inspection.
Are services responsive at this service
This was a responsive inspection and we did not consider this as part of the inspection.
Are services well led at this service
We did not see any evidence of effective governance arrangements in place to evaluate the quality of the service and improve delivery.
During the inspection we were not provided with evidence of effective policies and risk management and control systems, including audits.
The management team had not taken sufficient measures to identify, assess and manage risks through any aspect of the service.
On the day of the inspection, we found that the service did not have robust recruitment procedures in place to ensure that all staff were appointed following a check of their suitability and experience for their role, together with robust pre-employment checks carried out.
We identified areas of poor practice and we informed the provider that they needed to make urgent improvements.
In summary, we consider that people may be exposed to the risk of harm due to:
- Insufficient equipment maintenance.
- Inadequate governance to monitor and assess the quality of service provided in carrying on the regulated activities.
- Inadequate recruitment processes to ensure all staff are of good character and have the required competence to carry out their roles.
- Inadequate procedures for ensuring the safety of children and vulnerable adults.
- Inadequate security of premises, equipment and vehicles.
- Lack of effective risk assessments carried out, including fire safety.
The service must take action to ensure that:
- Robust governance and risk management systems including fire safety are in place and understood by all staff.
- The service has effective and current policies in place that are understood by all staff.
- Recruitment processes are in place so all staff employed have the experience and competence required for their role, together with robust pre-employment checks.
- Staff are supported in their roles by effective supervision, appraisal systems and ongoing training.
- All equipment is fit for use and required checks and maintenance is carried out.
- Vehicles and premises security must be maintained.
- Robust safeguarding vulnerable adults and children procedures are in place and understood by all staff.
Importantly, the provider must take urgent action to ensure compliance with regulations 12 (Safe care and treatment), 13 (Safeguarding service users from abuse and improper treatment), 15 (Premises and equipment), 17 (Good governance), 18 (Staffing), and 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On this basis, the registered provider was subject to a Notice of Decision issued by CQC suspending its registration until 28 October 2015 and was not permitted to carry on any regulated activities until that time.
Professor Sir Mike Richards
Chief Inspector of Hospitals