The Care Quality Commission (CQC) has rated Mobile Medical Cover Ltd, an independent ambulance service based in Grimsby, North East Lincolnshire, inadequate overall.
CQC carried out an unannounced focused inspection in August of the patient transport service (PTS) and the urgent and emergency care service, to follow up on concerns found at the previous inspection in October 2020, where the provider was told to make more than 30 improvements to keep people safe.
Following this inspection, both services have been rated inadequate overall and in relation to whether they are safe and well-led. Urgent and emergency care has also been rated inadequate for being effective and requires improvement for being responsive. PTS has been rated requires improvement for being responsive and for being effective. Caring was not rated as it was not possible to collect enough evidence due to social distancing rules.
Mobile Medical Cover Ltd is an independent ambulance service. It provides a PTS, and urgent and emergency care cover at events. At the time of the inspection, the provider had no contract in place for PTS, but provided crews and ambulances to local healthcare providers when needed.
Sarah Dronsfield, CQC’s head of hospital inspection, said:
“When we inspected Mobile Medical Cover, we saw some improvements since our inspection last year, however we were concerned there were still areas which hadn’t been addressed so have issued them with a warning notice. This requires them to make rapid improvements in relation to the safety of care being provided, the environment in which people are being treated, as well as requiring the leaders to have better systems and processes in place to enable greater oversight of services being delivered.
“It was disappointing that despite being told to take action to improve cleanliness, their building and storage areas were dirty and disorganised, with sterile and non-sterile equipment being stored together. People were being put at risk of harm as they were cared for by staff who weren’t taking enough measures to protect them against infection as they weren’t following their own cleaning guidance. We inspected two ambulances which staff informed us were ready to use, but both were visibly dirty.
“We found events staff didn’t receive a formal induction or training and were told this would be done on site during the start of their shift. However, we didn’t see any evidence that their competency was assessed, putting people at risk if they fell ill, as staff might not have the skills to treat them.
“There were also serious fire safety concerns in their main building which were putting staff in danger. Medical gases weren’t being stored in a safe way, there were no fire safety risk assessments and fire extinguishers were out of date.
“We have fed back our findings to the provider and told them they must make improvements as a matter of urgency. We will continue to monitor them closely to ensure that these take place. If we feel sufficient improvements have not been made, we will not hesitate to take further action.”
Inspectors found the following areas of concern:
- The service did not control infection risk well
- Staff did not thoroughly assess or record risks to patients
- There was no robust system in place for recruiting staff working at events. There was no evidence that employer references were requested or that disclosure and barring checks (DBS) checks were carried out
- The service did not manage or store medicines, including medical gases, safely
- No evidence the service had processes in place to share lessons learned from safety incidents
- Fire and health and safety risks had not been addressed at the service’s premises
- Managers did not adequately monitor the effectiveness of the service
- Not all staff had access to information such as company policies and procedures
- Leaders did not always run services well using a reliable information system
- Staff were not always clear about their roles and accountabilities
- Staff did not understand the service’s vision and values, or how to apply them in their work
- The service did not engage well with the community to plan, manage and improve services.
However:
- The service had enough staff to care for patients
- Patient transport staff had training in key skills and understood how to protect patients from abuse
- Staff appeared caring and worked together to provide effective care
- Key services were available seven days a week
- The service had several mechanisms in place for people to give feedback.
Full details of the inspection are given in the report published on our website.
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