The service transports patients to local NHS emergency departments as appropriate.

Patients not requiring transfer to hospital receive first aid as appropriate. However, we did not inspect this as the provision of first aid it is not a regulated activity.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 22 March 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?

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 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 on duty at the time of the inspection could describe how they would act in response to a safeguarding concern.
• The service stored patient record forms in line with information governance guidelines.
• Patient report forms were comprehensively completed and reviewed by the lead paramedic following each transfer of a patient to hospital.
• Staff followed evidence-based care and treatment and nationally recognised best practice guidance, which included the most recent guidelines from the Joint Royal College Ambulance Liaison Committee (JRCALC).
• The service had processes in place to ensure all staff employed were suitably qualified and experienced to carry out the duties required within their roles.
• 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.

However, we found the following issue that the service provider MUST improve:

• The provider does not have a policy in place to describe the policy and procedure to use for the application of Duty of Candour.

We also found the following issues that the service provider SHOULD improve:

• The controlled drug register was stored on an open shelf and not locked away. This meant there was a risk records could be tampered with.
• Controlled drug stock levels were checked monthly. This meant if stock levels did not reflect actual stock it would be difficult to identify the point at which a mistake occurred.
• Staff received and shared information at informal briefings. However, this was not minuted; therefore, we could not be confident all staff received important information.

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. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals

Due to the nature of the service we were unable to speak with people who used the service. However, we did observe that one person visiting the medical centre for treatment was involved in discussions about their care and treatment. We noted that they were treated with respect and kindness by the paramedic assisting them.

We saw that some people who had used the service had contacted the provider to thank them for the care and treatment they had provided. One person wrote, “The care and treatment you gave was excellent and I cannot thank you enough.”

Before using the race track people signed to say that in an emergency situation they agreed to receiving care and treatment. Paramedics told us that, where possible, people were consulted and involved in making decisions about their care or treatment.

People using the race circuit and attending the race meetings were given the care and treatment they required, when they needed it and also in emergency situations.

We found that the provider worked in cooperation with others involved in the care, treatment and transportation of people using the service.

Effective infection control procedures were in place and monitored to ensure people's safety and welfare.

There were sufficient numbers of technical and paramedic staff provided to crew the two ambulances used.

The records held ensure that people are protected against the risks associated with unsafe or inappropriate care and treatment.

Due to the nature of the service we were unable to speak with people who used the service or observe any care or treatment given. We saw that some people who had used the service had contacted the provider to thank them for the care and treatment they had provided. One person wrote, “I cannot thank you enough for the excellent care and treatment you gave.”

Where possible, people were asked for their consent before care or treatment was carried out. Paramedics spoken with told us that they respected the wishes and decisions people made about their care and treatment.

People using the race circuit and attending the race meetings were given the care and treatment they required, when they needed it and also in emergency situations. Records were held that contained details about the patient, incident, treatment and health monitoring action carried out.

Effective infection control procedures were in place and monitored to ensure people's safety and welfare.

Recruitment checks were carried out on staff members prior to their starting work to ensure that they were suitable to work as part of the ambulance staff team.

People who used the service were asked for their opinions on the care and treatment they received. They were protected because systems and records were audited.

Motorsport Vision – Snetterton Circuit is operated by Motorsport Vision Limited. MSV is an independent ambulance service near Norwich, Norfolk. The service assesses and provides emergency medical treatment to visitors, staff and event participants at Snetterton Circuit. The service has two emergency ambulances to allow for the transfer of patients to hospital, and one rapid response vehicle (for on-site use only).

We inspected this service using our comprehensive inspection methodology. We carried out a short noticed announced part of the inspection on 12 September 2018 along with a short notice announced visit to the service on 25 September 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? 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.

The main service provided by this hospital was emergency and urgent care through the provision of first and medical cover for events. The service also transports patients from the circuit site to hospital in the event of a medical emergency. This falls under the scope of regulation.

Services we rate

Our rating of this service was good overall.

We found the following areas of good practice:

• Staff were knowledgeable around incident reporting processes and the duty of candour.
• Staff were clear in their responsibilities to identify and report safeguarding concerns.
• The service was taking effective steps to prevent and control the spread of infection.
• Equipment and vehicles were well maintained.
• Medical records were complete and demonstrated timely assessment of pain and subsequent administration of pain relief.
• The service provide care that was based on national guidance.
• Staff assessed pain levels in a timely manner with evidence of regular analgesia.
• Staff described steps they would take to ensure a patient’s dignity and privacy was respected.
• The service had systems in place to offer staff support in the event of witnessing traumatic events.
• The service was planned in advance to meet the needs of visitors, participants at events and circuit staff.
• The service met the individual needs of patients.
• Patients could access the service in a timely and efficient manner with rapid on scene arrival times.
• The service had systems and processes in place to handle and respond to complaints.
• Staff described an open and honest culture within the service, stating they felt ‘respected and valued in their role’.
• The service had a clear leadership structure in place.
• Staff knew the service’s vision and were passionate about providing the best emergency pre-hospital care possible.
• All staff described an open and transparent culture within the service.

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

• There was a lack of documented staff engagement and minutes of any meetings were not documented to demonstrate that key issues or concerns had been shared with staff.
• The level of safeguarding training that staff had completed was not recorded.
• Some policies and risk assessment had not been regularly reviewed in line with company recommendations. A local risk register should also be maintained for service oversight.
• Patient feedback should be monitored and recorded to improve the service.

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 are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals