IAS Medical is operated by IAS Medical Limited. The company provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 16 to17January 2018, along with an unannounced visit to the on 29 January 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.

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 issues that the service provider needs to improve:

• The service had limited systems to monitor the quality and safety of the service. The use of audits, risk assessments and recording of information related to the service performance was inconsistent.
• The service did not have systems to ensure all staff were up-to-date with other training requirements.
• The service did not have an effective policy for safeguarding children and for protecting vulnerable adults from abuse. The policy did not contain the name of the safeguarding lead and contact information for the appropriate local authority safeguarding children and vulnerable adult’s team.
• The medicines management policy had not been adapted by the service. It did not contain what medicines were used and who was responsible for administering them. There were no patient group directions (PGD) for supplying and administering medicines. A patient group direction allows some registered health professionals (such as nurses) to give specified medicines (such as painkillers) to a predefined group of patients without them having to see a doctor.
• The service did not have a recruitment policy. Appropriate criminal records checks through the disclosure and barring service (DBS) had not been carried out for 11part-time medical staff.
• Appraisals had not been completed for the 11 part-time medical staff.
• The service did not have a formal process to collect feedback from patients to monitor the quality of the service.

However, we found the following areas of good practice:

• Staff were committed to providing the best quality care to patients. Staff displayed a caring and compassionate attitude and took pride in the service they were providing.
• We observed good multidisciplinary working between ambulance crews and other NHS staff in preparation for moving patients.
• The management team worked with the NHS hospital trusts to provide services which met the needs of local people.
• Staff were well supported by the management team; they told us the management team were friendly and approachable.
• The leadership structure was clear with an operations manager and management team who were responsible for co-ordinating the work of the ambulance crew.
• The process for checking driving licences was robust. These checks were completed prior to commencement of employment. We found staff had a record of the completion of a driving licence check. The service had an electronic system which recorded these driving licence checks.
• There were arrangements for ongoing checks for driver competence, such as spot checks or ‘ride outs’ by a driving assessor. The driving assessment was provided by an external provider. We saw records which showed the outcome of the assessment was discussed with the drivers.

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.

Ellen Armistead Deputy Chief Inspector of Hospitals (North of England) on behalf of the Chief Inspector of Hospitals