A F J is operated by A F J Limited. The service provides patient transport.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 4 July 2018 and 10 July 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 at the time of this inspection we did not have the power 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 concerns that the service provider needs to improve:

• Staff were not trained in safeguarding children level two.

• The provider did not engage with patients to sufficiently to assess the quality of its services.

• The provider did not have an up-to-date risk register.

• The provider did not have a medicines management policy or procedure for the administration of oxygen.

• The provider did not have a safeguarding policy that included specific elements such as female genital mutilation (FGM), modern slavery or the risk of being drawn into terrorist activity.

• The provider did not have a patient criteria to assess patients eligibility for the service.

• The provider did not have information available for patients on how to make a complaint.

• The provider did not have a duty of candour policy in place.

• Staff did not follow the services policy on infection prevention control in relation to glove use and used gloves when they were not required.

• The provider did not have access to an interpreter.

• The provider did not have a Mental Capacity Act (2005) policy or a consent policy in place.

• The provider did not have any general staff meetings.

However, we also found the following areas of good practice:

• The service employed competent staff and ensured all staff were trained appropriately to undertake their roles.

• Vehicles were visibly clean, tidy and well maintained. The service was owned by a company who also owned a garage so any repairs were completed quickly.

• The service had enough skilled staff to safely carry out the requirements of the service.

• Handovers at the sending and receiving establishments were informative and detailed, led by AFJ staff.

• All patient interactions were delivered in a sensitive and dignified way.

• Leaders had the skills, knowledge, experience and integrity they needed to ensure the service met patient needs. The management team described how they strived to be professional, open and inclusive.

• The organisational culture promoted staff wellbeing. The manager was always available for staff queries and concerns.

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 five requirement notices that affected this service. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central Region), on behalf of the Chief Inspector of Hospitals