LSA House

Updated 12 October 2022

LSA House is operated by the registered provider LSA Secure Limited. It is an independent ambulance service. The provider was registered with the Care Quality Commission in 2018 to deliver a patient transport service. In June 2020, the provider amended their registration with the Care Quality Commission so they could provide an emergency and urgent care service to support the country’s response to the COVID-19 pandemic. However, at the time of this inspection, they had not delivered any emergency and urgent care.

The service predominantly provides secure patient transport for patients with mental health conditions who may or may not be detained under the Mental Health Act 1983.

The service is registered to carry out the following regulated activities:

• Transport, triage and medical advice provided remotely

• Treatment of disease, disorder or injury

LSA House had a registered manager who is responsible for the carrying out of the regulated activities.

The main service provided by this service was Patient Transport Services. Where our findings on Patient Transport Services also apply to other services, we do not repeat the information but cross-refer to the Patient Transport Services service level.

We inspected this service in September 2021 and published the report in January 2022, at which point the service was placed in special measures. This was because the service was rated as Inadequate overall. Providers placed in special measures are inspected again within six months of publication. This inspection was to check sufficient improvements had been made.

In September 2021, we inspected the service and as a consequence of that inspection we rated the service as Inadequate because:

• The governance and leadership of the service did not fully protect the safety of the patients. Staff did not always fully complete patient risk assessments and patient risk assessments did not consider physical health needs. Safeguarding of patients from abuse and improper treatment was not fully assured. Guidance for staff was not clear, policies and procedures did not always relate to the service provided and did not always include current national guidance.
• Governance and leadership of the service did not effectively manage performance. The leadership did not use monitoring of the service to support ongoing improvements which could potentially put patients at risk of avoidable harm. The service did not have a system to effectively manage risks or audit the quality of the service.

Updated 12 October 2022

Our rating of this service improved. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. The service controlled infection risk well. The service managed safety incidents well and learned lessons from them.
• Staff assessed patients’ food and drink requirements. The service met agreed response times. Managers made sure staff were competent.
• Staff treated patients with compassion and kindness and respected their privacy and dignity. They provided emotional support to patients, families and carers.
• The service made it easy for people to give feedback. People could access the service when they needed it. The service planned care to meet the needs of local people.
• Staff understood the service’s vision and values. Staff felt respected, supported and valued. The service engaged well with patients and the community to plan and manage services.

However

• Staff assessed physical risks to patients, but did not document mitigations, actions or the impact of those risks. This was identified at the previous inspection.
• The adult safeguarding policy was unclear, inaccurate and contradictory and there was no contraband policy to support staff who were required to search patients for smuggled goods.
• Managers did not monitor the number of staff days off, to ensure that there was adequate weekly rest periods and were unsure of official processes for notifying CQC of notifiable safeguarding concerns.

Updated 12 October 2022

Our rating of this service improved. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. The service controlled infection risk well. The service managed safety incidents well and learned lessons from them.
• Staff assessed patients’ food and drink requirements. The service met agreed response times. Managers made sure staff were competent.
• Staff treated patients with compassion and kindness and respected their privacy and dignity. They provided emotional support to patients, families and carers.
• The service made it easy for people to give feedback. People could access the service when they needed it. The service planned care to meet the needs of local people.
• Staff understood the service’s vision and values. Staff felt respected, supported and valued. The service engaged well with patients and the community to plan and manage services.

However

• Staff assessed physical risks to patients, but did not document mitigations, actions or the impact of those risks. This was identified at the previous inspection.
• The safeguarding policy was unclear, inaccurate and contradictory and there was no contraband policy to support staff who were required to search patients for smuggled goods.
• Managers did not monitor the number of staff days off, to ensure that there was adequate weekly rest periods and were unsure of official processes for notifying CQC of notifiable safeguarding concerns.

Updated 12 October 2022

At the time of inspection, the service was registered to provide emergency and urgent care. However, the service had not yet completed an emergency and urgent care transfer.