MBS Medical Limited is based in Maidenhead, Berkshire. The service provides a patient transport service and medical cover at events across the South of England.

Services are staffed by trained paramedics, ambulance technicians, ambulance care assistants and first responders on a casual basis.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 2 March 2017. We did not carry out an unannounced inspection as the service was not carrying out any duties during the unannounced time period.

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:

• Staff followed infection prevention and control procedures to reduce the spread of infection. They kept vehicles clean, tidy and well stocked.

• The system for servicing vehicles was effective. All had an up to date MoT and insurance, and schedules were in place to monitor servicing dates with accurate records kept.

• There were recruitment processes so all staff employed had the experience and competence required for their role. Appropriate pre-employment checks had been carried out.

• The service had a system for handling, managing and monitoring complaints and concerns.

• The service operated a patient transport service and event cover, which was mainly at weekends at times agreed by the event organiser. They provided an appropriate number of vehicles and staff dependent on the needs of the specified transport or event.

• Feedback seen from patients and event organisers was overwhelmingly positive.

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

• The management of medical gasses was not robust and needed to be improved.

• The service was not auditing infection control procedures and could therefore not assure themselves of their effectiveness.

• The service had yet to implement a proposed preventative maintenance schedule for equipment carried on vehicles.

• There was no provision on vehicles to support people who were unable to communicate verbally or who did not speak English.

• The service had no child restraints on their vehicles.

• Staff were aware of safeguarding and had received training however, there was no safeguarding policy and we were not assured of the level of training received was relevant to role.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve.

We also issued the provider with three requirement notices that affected Patient Transport Services.

Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

We spoke to people who used the service. They were complimentary about the professionalism, courtesy and flexibility of the service. One person told us "I would recommend MBS and have done so already", "Staff are polite and they always do a good job".

The majority of care and treatment provided by the service were to injuries resulting from 'motocross' and equestrian events. The service was aware of the need to call for emergency service back-up, if injuries were serious and/or life threatening. This occasionally required liaison with the emergency services and air ambulance support.

We looked inside two of the services ambulances and saw they provided patients with privacy whilst being transported. The windows of the ambulances were fitted with obscured glass which meant people could not see the patient receiving treatment inside.

We saw the ambulance was fully equipped to deal with medical emergencies. There was oxygen and suction equipment on board. A medical kit containing emergency equipment including defibrillator and other first aid and resuscitation equipment.

One person told us "MBS always do a good job for us. Staff are skilled and professional".