11 April 2017
During an inspection looking at part of the service
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:
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There was insufficient focus on infection prevention and control.
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The management of waste did not meet current guidance.
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Segregated medical gasses were not stored in line with guidance.
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Staff did not manage medicines appropriately.
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Equipment used to provide services to patients was not regularly serviced.
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We found numerous consumables that had passed their expiry date.
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There were fire safety and health and safety risks identified.
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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.
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There were unclear audit arrangements and there was no auditing of patient transport services.
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The registered manager had difficulty locating key documents and information when requested and was unable to provide us with documents and records.
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There were limited systems to collect feedback from patients.
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There was a lack of processes to assess, monitor and mitigate risks relating to the health and safety and welfare of patients and others.
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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:
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Transport services, triage and medical advice provided remotely
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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:
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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)’.
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Medical gasses were still not stored in line with current guidance.
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Equipment had not been serviced or maintained since our previous inspection although there was evidence of some planning to commence this.
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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.
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We found items of equipment that were out of date, despite assurances equipment had been checked.
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There was a lack of systems and processes to assess, monitor and improve the quality and safety of services.
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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.
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The action plan rejected by the CQC had not been updated at the time of this inspection.
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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.
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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.
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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:
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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.