ABC Event Cover is operated by ABC Training Services Limited. The service provides emergency and urgent care. The service provides first aid and medical cover at events and transports people from the event site to hospital in the event of a medical emergency.

We inspected this service on 16 January 2019 using our comprehensive inspection methodology. We gave the provider 48 hours’ notice of the inspection. This was so we could ensure the location would be staffed on the day of the inspection.

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? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

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 rate

This is the first ratings inspection of this service. We rated it as Requires improvement overall.

We found areas of practice that require improvement:

• Staff understood how to protect patients from abuse. However, effective systems were not in place to ensure that all staff were suitably trained in safeguarding. Safe systems were not in place to ensure staff were suitable to work with vulnerable people.

• The leadership team were visible and approachable. However, we could not be assured that the directors were suitable to carry out their roles as there were no effective systems in place that evidenced that appropriate checks relating to directors had been completed.

• The service provided mandatory training in key skills to non-registered staff and made sure these staff members completed it. However, no formal system was in place to ensure registered staff had completed mandatory training.

• There were systems in place to ensure staff were competent to work in their roles. However, some parts of these systems were not formalised to ensure the staffs’ development needs were consistently assessed and monitored.

We found good practice in relation to the following areas of practice:

• The service had systems in place to manage patient safety incidents.

• The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.

• The service had suitable premises and equipment and looked after them well.

• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.

• The service had enough staff to provide the right care and treatment.

• Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

• The service followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right dose at the right time.

• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.

• Staff assessed and monitored patients regularly to see if they were in pain. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.

• Staff worked with other professionals and agencies to provide coordinated care.

• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. They followed the service’s policy and procedures when a patient could not give consent.

• Staff understood their roles and responsibilities under the Mental Capacity Act 2005. They knew how to support patients experiencing mental ill health and those who lacked the capacity to make decisions about their care.

• Staff described how they cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.

• Staff told us how they provided emotional support to patients to minimise their distress.

• Staff involved patients and those close to them in decisions about their care and treatment.

• The service planned and provided services in a way that met the needs of local people.

• The service took account of patients’ individual needs.

• The service had systems in place to treat concerns and complaints seriously, investigate them and learn lessons from the results, and share these with all staff.

• The service had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff.

• The leadership team promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

• The service used a systematic approach to continually improve the quality of its services.

• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

• The service engaged with patients, staff, the public and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.

• The registered manager was committed to improving services by learning from when things went well and when they went wrong, promoting training and innovation.

Following this inspection, we told the provider that it must take some actions to comply with the regulations. We also issued the provider with three requirement notices that affected urgent and emergency services. Details are at the end of the report.

Professor Ted Baker

Chief Inspector of Hospitals

ABC Event Cover is a not for profit service operated by ABC Training Services Limited. The service provides emergency and urgent care at events.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 16 January 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 we take regulatory action as necessary.

We found the following areas of good practice:

• There were clear policies in place based on national guidelines to outline processes for assessing and responding to patient risk. Staff demonstrated comprehensive understanding of these policies and how to treat patients in accordance with these policies.
• We saw the management of medicines at the base and on vehicles was robust and exceeded the standards set by nationally recognised guidelines.
• We saw that vehicles and equipment were clean and that there was documentation in place to ensure that high standards were maintained.
• We saw that patient records were well documented, audited and kept securely.
• We saw positive feedback from patients and event organisers which showed staff were compassionate.
• Staff within the service had completed training to assist with meeting the needs of individuals including patients living with dementia and learning disabilities.
• We saw processes in place to ensure risks were monitored and improvements made where required.
• There was a positive culture within the organisation with approachable and motivating leaders.

However, we also found the following issues that the service provider needs to improve:

• We did not see a clear policy in place for recording incidents of all kinds. The policy that was in place was specific to accidents and required review and update to ensure no harm or near-miss incidents could be recorded and learnt from.
• Policies for infection prevention and control, safeguarding adults, Mental Capacity and Deprivation of Liberty and complaints were out of date and required a review.
• There was a lack of understanding amongst the staff we spoke with in regards to the involvement of the patient and their family members in the case of a Duty of Candour incident.
• We saw that there was a lack of understanding of the Mental Capacity Act 2005 amongst first aid trained staff; although the service had arranged training for this specific topic to be completed in 2017.
• There was a lack of information available to patients and their families regarding raising complaints or concerns with the service.

Following this inspection, we told the provider that it should take some actions, even though a regulation had not been breached, to help the service improve.

Ellen Armistead

Deputy Chief Inspector of Hospitals