The Care Quality Commission (CQC) has rated a Maidenhead-based independent ambulance service as inadequate and imposed conditions on the registration of the service to keep people safe.
Cookham-based LSA House has also been rated inadequate in relation to whether it is safe, effective and well-led and that it requires improvement for its responsiveness to people’s needs. The CQC added it has not been rated in the caring domain, as there was insufficient evidence to do so.
LSA House, an independent ambulance service operated by LSA Secure Limited, is registered to provide a patient transport service and predominantly provides secure transportation for patents with mental health conditions.
In June last year, the provider amended its registration so that it could also offer an emergency and urgent care service during the Covid-19 pandemic.
At the time of the CQC inspection, the first inspection of LSA House since the provider registered with CQC in 2018, it had not delivered any emergency and urgent care.
Inspectors found the following areas of concern:
- That the governance and leadership of the service did not fully protect the safety of patients.
- The service did not control all areas of infection risk well.
- That staff did not keep detailed records about the use of restraint on patients and they did not always complete patient risk assessments.
- That patient safety incidents were not managed well and the use of restraint on patients was not considered to be an incident.
- That staff did not always ensure that restraint equipment was safe to use.
- That safeguarding of patients from abuse and improper treatment was not fully assured.
- That guidance for staff was not clear. Policies and procedures did not always relate to the service provided.
- That staff did not fully understand their role in supporting patients who lacked the mental capacity to make decisions.
- That the governance and leadership of the service did not always manage performance, nor did it use monitoring of the service to support ongoing improvements which could potentially put patients at risk of avoidable harm.
- That there were no processes to get feedback from organisations who used the service and there were limited processes for people to give feedback and raise concerns about care.
- That the service did not have a system to effectively manage risks or audit the quality of the service.
- Data was not used to understand performance and to make decisions and improvements.
- That the service did not have structured meetings to ensure performance was reviewed.
However, CQC inspectors also found the service had enough staff to care for patients and people could access the service when they needed it.
Staff felt respected and valued and they demonstrated understanding about the discrimination that mental health patients may experience.
Cath Campbell head of hospital inspections at the CQC’s said the regulator had numerous concerns following its inspection of LSA House and told the provider that it must take action to ensure the service complied with legal requirements to keep people safe.
“We have now imposed conditions on the registration of both of the core services that the provider offers, namely patient transport and urgent and emergency care,” she said.
“We have told the provider that it must send us a report outlining what action it intends to take to address our concerns. We will continue to monitor the service to ensure that improvements are made and fully embedded.”
Health & Protection has contacted LSA House for comment.