I visited a friend last week who owns a small business. His computers are managed by a local consulting firm, but he was beginning to suspect that their advice was less than stunning, and so asked my opinion.
A quick look at the computers showed a few interesting snippets. There weren't any fundamental issues, but it was clear that for all the 'service' they were getting, nobody, either at the business, or the consulting firm, were doing any kind of maintenance on the machines, only fixing them when they went wrong. This was true, even though the company in question charged both a monthly fee (retainer) in addition to an hourly fee went someone was called out.