Background to this inspection
Updated
16 May 2018
Medevent Medical Services Limited is operated by Medevent Medical Services Limited. The service opened in 2006. It is an independent ambulance service in Maidstone, Kent. The service primarily serves the communities of Kent.
The service has had a registered manager in post since 2011. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is managed.
Medevent Medical Services Limited provides non-emergency ambulance medical cover at events, such as music concerts, aviation shows and rugby matches, for both adults and children. However, the service has undertaken three emergency transfers in the last 12 months from events.
Medevent Medical Services Limited fleet consists of three vehicles; however, at the time of inspection one vehicle was off the road. The ambulances were fitted with a stretcher, three seats, and a wheel chair. There are no additional employees at this service. The service employs staff to help at events on a casual contract basis.
Updated
16 May 2018
Medevent Medical Services Limited is operated by Medevent Medical Services Limited. They are an independent medical transport provider based in Maidstone, Kent. The service provides medical cover at events such as music events, aviation events, and rugby matches for both adults and children. Trained paramedics, emergency care technicians, and ambulance care assistants are used to staff the services. The service has undertaken three emergency transfers in the last 12 months from events; it is these journeys that fall within the scope of registration with the CQC.
In England, the law makes event organisers responsible for ensuring safety at the event is maintained, which means that medical cover comes under the remit of the Health & Safety Executive (HSE). Therefore, the Care Quality Commission (CQC) does not regulate services providing ambulance support at events and this is not a regulated activity. The main service was event work, which the CQC does not regulate. Therefore, these services were not inspected.
The policies, procedures and expectations on staff including completing of patient report forms, administration of medicines, are the same for both the regulated activity and non-regulated activity. Therefore, we used these as evidence for this report.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 5 December 2017.
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.
Services we do not rate
We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.
We found the following issues that the service provider needs to improve:
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There was an incident reporting system but a culture of incident reporting was not embedded in the service. Staff reported incidents verbally, but there was no formal recording of incidents or their severity, or how learning from incidents had been shared.
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There were limited governance arrangements to monitor or evaluate the quality of the service and improve delivery.
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The service did not have a business continuity plan. This meant the provider could not be assured that staff knew what to do in the event of an emergency, such as phone or radio system failure.
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The service did not have a risk register, so they might not have identified, assessed, and mitigated key risks and issues.
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The service did not have an effective system to ensure staff were up to date with competencies necessary to perform their jobs.
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The service did not have an effective system to ensure staff were up to date with their mandatory training. Following the inspection the service sent us a structured mandatory training plan for all staff.
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We found intravenous fluids stored on vehicles outside of recommended safe temperatures. The registered manager removed the fluids immediately from the vehicles and stored them in an appropriate location.
However, we found the following areas of good practice:
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The registered manager demonstrated a dedication and motivation to improve the service. They spoke openly and honestly about the introduction of new systems and processes being implemented, or in their infancy and needing further development.
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Patient report forms were fully completed and legible in line with guidance from the Joint Royal Colleges Ambulance Liaison Committee clinical practice guidelines. From review, we saw the service had adapted the patient report forms to include additional information, such an additional check for pain.
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Staffing levels and skill mix was reviewed, planned and appropriate to ensure patients received safe care and treatment.
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Emergency equipment was available, maintained, and serviced. Staff assessed and responded appropriately to potential risks to patients.
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Medicines were well managed by the service. We saw there were effective systems to ensure medicines, including controlled drugs, were checked in and out at the beginning of an event.
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The service was aware of national guidance relating to the provision of medical cover at an event. This was reflected in the services policies and procedures. However, we found some policies lacked some of the latest guidance and best practice references.
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.
Amanda Stanford
Deputy Chief Inspector of Hospitals (London and South), on behalf of the Chief Inspector of Hospitals
Emergency and urgent care
Updated
16 May 2018
We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary. As there was only one core service, please see summary of findings below.