Inter-County Paramedic Riverside Park is operated by Inter-County Paramedic Ltd. The independent ambulance service provides bespoke medical cover to sporting events which included medical care and treatment on the event site (this activity is not regulated and therefore is not included in this report) and conveyance to hospital for patients that required more definitive care. The care and treatment provided during conveyance to hospital is regulated and is the focus of this inspection. The service was inspected under the patient transport service framework.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 1 February 2017 along with two unannounced visits to the service on 8 and 14 February 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?

The only service provided by Inter-County Paramedic Ltd was patient transport services.

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 a system in place for reporting, recording and learning from incidents.

• There were robust systems in place to maintain patient safety which included medicines management, infection prevention and control and vehicle maintenance.

• There was a lead for safeguarding and staff knew who this was. Staff knowledge around safeguarding vulnerable adults and children from abuse was evident.

• The service stored patient record forms (PRFs) appropriately and audited to ensure good completion by staff.

• Staff followed evidence-based care and treatment and nationally recognised best practice guidance, which included the Joint Royal College Ambulance Liaison Committee (JRCALC) guidelines from 2016.

• The service had processes in place to ensure all staff who were employed were suitably qualified, medically fit and experienced in their roles.

• There was good coordination with other members of the multidisciplinary team and staff from the organisations medical cover was provided for.

• Staff had a strong focus on providing a caring, compassionate and professional service.

• Measures were taken to meet the individual needs of patients treated.

• There was a system for handling, managing and monitoring complaints and concerns. The service had not received any complaints from January 2016 to January 2017.

• Staff felt valued by the manager and proud to work for the service.

• The service had taken steps to improve and innovate their systems for stock management and maintaining a responsive service at events they are providing a medical cover for.

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

• The service did not have a Home Office licence in place for the management of controlled drugs.

• The service did not have a system in place to regularly receive medicine and medical device alerts.

• There was no risk register in place to give an overview of all known risks.

• Staff were unaware whether there was a vision and strategy for the service.

• There were limited systems in place to measure quality and service improvement.

• There was an appraisal process in place, however at the time of our inspection, only 39% of staff had received one.

• Not all staff had completed mandatory training. At the time of our inspection, compliance with mandatory training was between 54% and 88%.

Ellen Armistead

Deputy Chief Inspector of Hospitals

We spoke with five people who worked for organisations that used the service. People spoke highly of the service they received. Comments included ‘‘We receive a professional and reliable service. I can’t fault it; the staff have appropriate knowledge and skills and work with us; Inter-County Paramedics is an exceptional service and provides high standards; we are impressed by the way the service operates; great provider and service.’’

The care and treatment was delivered in a way that ensured people’s welfare and safety. Recent satisfaction surveys showed that people were satisfied with the care and treatment they received.

The service was well managed. People were cared for by staff who were supported to deliver care and treatment safely. Staff received appropriate support, training and an appraisal of their work. Staff told us they received appropriate supervision and induction training. However formal systems were not in place to show this.

Arrangements were in place to ensure that the vehicles were clean, reliable and roadworthy. The equipment and appliances were properly maintained and safe to use.