The Medical Centre is operated by Polaris Medical limited. The ambulance service provides emergency and urgent care.

We inspected this service using our comprehensive inspection methodology. We carried out announced inspections on 27 February 2018 and 15 March 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.

The main service provided by this service was emergency and urgent care.

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 provider demonstrated good operational and people leadership but needed to improve governance processes within the organisation. Overall, the leaders had a strong focus on providing good quality care.

• Arrangements were in place for escalating issues with contracting trusts. Both NHS trusts identified a contract manager and monthly contract meetings took place to monitor performance and provide feedback regarding most incidents and referrals.

• The service used an electronic based programme to monitor training requirements and staff attendance at training.

• Completion of risk assessments for film and event work ensured the correct vehicle; equipment and appropriately trained crew were assigned to meet the needs of the patient.

• The service had a formal process for the reporting of patient incidents, and followed their own policy for reporting, investigating and learning from incidents.

• The service managed infection prevention and control well and staff followed their policies and procedures.

• Staff understood what their safeguarding responsibilities were and what constituted as abuse.

• We found all vehicles were in good condition, well maintained, visibly clean and tidy.

• Medical gases were stored safely and securely and equipment was maintained, clean and in good working order

• Staff received mental capacity act training and showed awareness of consent issues.

• Staffing levels were sufficient to meet the patient and service’s needs.

• The service used its vehicles and resources effectively to meet patients’ needs.

• Staff had access to trained practitioners who could proactively support personnel following traumatic events.

• Staff were committed to providing the best quality care to patients and we observed staff demonstrating patience, kindness and respect.

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

• General governance was not robust and did not demonstrate a monitoring of the quality of the service.

• The service did not have an appraisal process, which the managers acknowledged prior to our visit. The lack of appraisal process could result in staff having unmet training needs. During inspection we were assured an appraisal system was under development.

• The provider did not have a record of all incidents or safeguarding referrals reported through trust processes and relied on the contracting trust to feed the information back.

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 one requirement notice that affected urgent and emergency care. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals London and South, on behalf of the Chief Inspector of Hospitals