CIPHER Medical Consultancy Limited is operated by CIPHER Medical Consultancy Limited. The service provides emergency and urgent care by providing a ‘see and treat’ service. The service was provided for patients who were classified as a category three which is a low risk emergency. The service transports some patients who had been seen and treated and required additional care. These patients were transferred to the hospital or urgent care centre.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 30 April 2018.

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 areas of good practice:

• The service had systems to monitor the quality and safety of the service. The use of audits, risk assessments and recording of information related to the service performance was to a high standard.
• The managers were clear about the vision and strategy of the organisation to make sure it provided high quality care.
• The management team worked with the NHS ambulance trust to provide services, which met the needs of local people.
• The service had enough skilled staff to safely respond to emergency calls. The staffing levels and skill mix of the staff met the patients’ needs.
• All cars were visibly clean and systems were in place to ensure cars were well maintained.
• All equipment necessary to meet the various needs of patients was available.
• There were effective recruitment and systems to support staff.
• The service employed competent staff and ensured all staff were trained appropriately to undertake their roles. Staff had a clear understanding of the Mental Health Act (1983) and were aware of their role and responsibilities.
• Staff demonstrated exceptional pride in their role and we saw examples where they had shown care and compassion when treating patients.
• We saw that the leadership of the service was open, approachable and inclusive and staff confirmed this.

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

• The service did not carry out infection control and hand hygiene audits to measure the quality and effectiveness of the service delivered.
• Hazardous substances such as cleaning products were not locked away and stored securely
• The service was not meeting the Accessible Information Standard (AIS) to ensure people who have a disability, impairment or sensory loss get information that they can access and understand.

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. Details of these are at the end of the report.

Ellen Armistead Deputy Chief Inspector of Hospitals (North Region), on behalf of the Chief Inspector of Hospitals.