Grimsby ambulance service rated ‘Inadequate’ by CQC over dirty vehicles

An independent ambulance service based in Grimsby has been rated as ‘Inadequate’ after an unannounced inspection by CQC highlighted concerns including dirty vehicles and staff training.

Mobile Medical Cover Ltd was formed in 2012 and provides a Patient Transport Service (PTS), and urgent and emergency care cover at events, which is regulated by CQC (Care Quality Commission) who they registered with in 2016. The service also provides medical cover on film sets and for the Ministry of Defence, but this does not fall within the CQC scope of regulation.

Concerns were flagged up in a previous inspection in October last year, listing 30 improvements the firm needed to make to keep people safe. CQC carried out an unannounced follow-up inspection at the provider’s operation base on Spencer Street in Grimsby on August 10 this year – read CQC’s full report here, which was published on Wednesday, November 10.

During the most recent inspection in August, two ambulances were flagged as “ready to use” despite being “visibly dirty” and CQC said the vehicle cleaning records showed that they were not all cleaned daily.

Mark Furneaux, Managing Director at Mobile Medical Cover Ltd, told The Lincolnite the firm has completed the actions required by CQC, and the two ambulances mentioned had just returned from a festival.

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) 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

Despite the long list of concerns, there were some positives found during the inspection:

• 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

As a result of the latest inspection, both services have been rated as ‘Inadequate’ overall, and in relation to whether they are safe and well-led. Urgent and emergency care has also been rated as ‘Inadequate’ for being effective and ‘Requires Improvement’ for being responsive.

The PTS has been rated as ‘Requires Improvement’ for being responsive and effective. The ‘Caring’ category was not rated, as CQC said it was not possible to collect enough evidence due to social distancing rules.

A warning notice was also served to the provider on August 19 this year, who were given a deadline by which they had to become compliant with the relevant regulations.

A long list of action CQC said the service must take includes ensuring all vehicles are cleaned and maintained in line with national guidance and company police, and ensuring outstanding mandatory training is completed as soon as possible.

CQC also said that at the time of the inspection, the provider had no contract in place for PTS, but provided crews and ambulances as required to local healthcare providers to facilitate patient transfers and discharges, which are usually booked on a week by week basis.

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.”

Mark Furneaux, Managing Director at Mobile Medical Cover Ltd, told The Lincolnite : “During our recent inspection the CQC highlighted a number of areas that needed some improvement.

“We have worked diligently over the last two months and have completed the actions required by the CQC to make the required changes to our systems and processes.

“Our vehicle cleaning and infection control procedures have always ensured all of our ambulances are cleaned above and beyond the standards expected.

“The two vehicles that the CQC mentioned in the report had just returned from a festival. They had not yet been through the deep cleaning process and were not in use until this had taken place.”