Ambulance Station is operated by Central Medical Services. The service provides emergency and urgent care and patient transport services. The service has a service level agreement with a local NHS ambulance service and other NHS organisations. It also provides emergency care provision at public events, which is not inspected by Care Quality Commission (CQC) because this falls outside of the scope of CQC registration.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 18 July 2017, along with an unannounced visit to the service on 24 July 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?

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 service which we regulate is patient transport services.

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:

• There were no never events or serious incidents reported in this service between April 2016 and April 2017.
• Staff we spoke with had a good understanding about duty of candour.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Infection prevention and control processes were in place and equipment had been checked in line with the service policy.
• Staffing levels were planned, implemented and reviewed to ensure patients received safe care and treatment at all times.
• Emergency equipment was readily available, maintained and serviced.
• Staff assessed and responded appropriately to potential risks to patients.
• Staff received training to provide them with the skills and knowledge required for their role.
• Medical record documentation was completed in line with national standards.
• Policies for care and treatment were in date, accessible and reflected relevant research and guidance.
• Patients received safe treatment and care was provided to a good standard.
• Patients told us that staff treated them with kindness, compassion, dignity and respect.
• Staff responded compassionately when patients needed help and supported patients emotionally. This was reflected in feedback from patients.
• Patients were able to provide feedback which was unanimously positive about the care and treatment they had received.
• Patients were involved and encouraged in making decisions about their care.
• Services were planned and delivered in a way which met the needs of the local population.
• Staff we spoke with were positive about local leadership.
• Staff told us that managers were both visible and accessible and that they would have no concerns in raising any issues directly with them should the need occur.

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

• At the time of inspection the service did not have an effective governance system in place to monitor activity and improvements.
• The fire extinguishers we reviewed were not all in date.
• The service did not have the correct warning signs displayed on the doors where cleaning chemicals were stored.
• A patient group directive (PGD) had not been signed off before a medication was stored on the vehicles for administration.

Heidi Smoult

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