Archived: W & N Training Limited Also known as Want Medical Services

Updated 6 July 2017

Want Medical Services (WMS) is operated by W & N Training Limited. The service opened in 2000, originally as a training centre. WMS is an independent ambulance company, based in Portslade (Brighton) offering event medical cover, medical repatriation, ambulance transport, first aid training and medical supplies across the South of England. From February 2016 to January 2017 there were 2,026 patients conveyed, all of which were booked on the same day.

The service has had the current registered manager in post since 2011.

In England, the law makes event organisers responsible for ensuring safety at the event is maintained, which means that event medical cover comes under the remit of the Health & Safety Executive. Therefore, services providing ambulance support at events are not regulated by the Care Quality Commission as events are not classed as a regulated activity.

The activities at WMS regulated by the CQC are; transport services, triage and medical advice provided remotely and the treatment of disease, disorder or injury.

The non-event service at WMS is small and has declined with changes in the way patient transport services have been provided in the region. WMS undertakes occasional transport work for private patients, health insurance providers (repatriation) and local NHS trusts.

CQC inspected the service in January 2014. During the inspection, CQC found breaches in regulations around infection control; however, the provider had satisfactorily addressed these issues during a follow up inspection in May 2014.

An inspection in February 2017 found a number of breaches in regulations around the cleanliness of the building and vehicles, the maintenance and servicing of equipment, lack of governance structure and ability to recognise and reduce risk and not meeting the requirements relating to information required to be kept in relation to persons employed in a regulated activity.

We carried out a short-notice (24 hours), focussed inspection on the 11 April 2017 to review the provider’s progress against the identified issues. We assessed if the provider had met required standards that would enable us to re-instate the provider’s registration.

We asked the provider to supply further documentary evidence by 21 April 2017 to demonstrate the required improvements had been achieved prior to the ending of the suspension of registration on 22 April 2017. We did not receive this information. Therefore, we suspended the provider’s registration for a further there months as we were not assured that their service was meeting the required standards of safety and quality. We will assess the provider’s progress before the end of this further suspension period to ensure that required standards are, or are likely, to be achieved when the regulated activity resumes.

Updated 6 July 2017

Want Medical Services (WMS) is operated by W & N Training Limited.

CQC inspected the service in 2014 and found issues around non-compliance in relation to infection control practices. An inspection later in the year found the provider to be meeting the required standards.

We completed a comprehensive inspection of Want Medical Services (WMS) on 14 February 2017 and found the following issues:

• There was insufficient focus on infection prevention and control.

• The management of waste did not meet current guidance.

• Segregated medical gasses were not stored in line with guidance.

• Staff did not manage medicines appropriately.

• Equipment used to provide services to patients was not regularly serviced.

• We found numerous consumables that had passed their expiry date.

• There were fire safety and health and safety risks identified.

• There was a lack of systems and processes to assess, monitor and improve the quality and safety of services. There was no formalised system of governance.

• There were unclear audit arrangements and there was no auditing of patient transport services.

• The registered manager had difficulty locating key documents and information when requested and was unable to provide us with documents and records.

• There were limited systems to collect feedback from patients.

• There was a lack of processes to assess, monitor and mitigate risks relating to the health and safety and welfare of patients and others.

• Staff records did not take into account the information required in ‘Schedule 3’ of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As a result of the above, CQC urgently suspended registration of the following regulated activities until 22 April 2017 to allow the provider to address the issues identified at the inspection:

• Transport services, triage and medical advice provided remotely

• Treatment of disease, disorder or injury

This meant the provider could not carry out these regulated activities.

The purpose of the 11 April 2017 inspection was to review the provider’s progress against the issues identified in February 2017 and assess whether the provider had met standards in order to lift the suspension on 22 April 2017.

This was an announced inspection that was focused on issues seen in the February report. Therefore, we did not look at all areas normally contained within an ambulance report.

At our 11 April 2017 inspection, we were not assured that people would be safe from avoidable harm and high quality care was not assured by the current governance arrangements. There was also insufficient assurance to demonstrate patients received effective care and services were not advertised in a way that ensured patients’ needs could be met.

We found the following issues:

• The premises and the vehicles still did not meet standards set out in the ‘Health and Social Care Act 2008 Code of Practice of the prevention and control of infections and related guidance (2015)’.

• Medical gasses were still not stored in line with current guidance.

• Equipment had not been serviced or maintained since our previous inspection although there was evidence of some planning to commence this.

• We found some out of date medicines although the provider told us these had all been checked. However, all stocks of controlled drugs had been surrendered to the local police.

• We found items of equipment that were out of date, despite assurances equipment had been checked.

• There was a lack of systems and processes to assess, monitor and improve the quality and safety of services.

• New policies had been formulated, however plans for implementing them were vague and did not include time frames or details regarding staff training. Plans did not include how policies were to be monitored and audited once they had been implemented.

• The action plan rejected by the CQC had not been updated at the time of this inspection.

• Audit activity, plans and schedules had still not been implemented. There was no evidence of how audit outcomes and details were to be reviewed or how audit formed a part of the governance structure.

• A risk register template had been set up, however this was empty. Therefore, risks had still not been identified, neither were plans to mitigate risks in place.

• Disclosure and Barring Service checks were requested by former employers or universities and not by WMS, which is not in line with recommendations set by the Disclosure and Barring Service.

However:

• The prescription only medicines were stored in a locked cupboard and were secured with digital key access. All stock inside the prescription only store was in date.

As a result, CQC extended the suspension of regulated activities until 21 July 2017.

Alan Thorne

Head of Hospital Inspections