Arriva Transport Solutions Ltd Canning Town is operated by Arriva Transport Solutions Ltd. The service provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 23 and 24 January2018.

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 areas of good practice:

• The provider introduced a new system of incident reporting in July 2017 and we were told that the quality of recording had improved since in terms of timeliness and accuracy.

• There was an effective system in place for staff to report safeguarding incidents and staff were confident about how to raise a safeguarding alert.

• Each vehicle we inspected had a complete service history and 12 week safety check and was visibly clean and free from contamination.

• NHS commissioners told us the provider demonstrated a continued desire to improve the quality of the service provided.

• Staff had regular appraisals.

• Crews were made aware of special notes to alert them to patients with pre-existing conditions.

• There was a robust process of induction and newly inducted staff were assigned a more experienced member of staff as their mentor.

• We observed how staff were respectful and kind in their interactions with patients when waiting in the hospital transport waiting area.

• Patients told us “the driver could not be better if he tried”, and “all the staff are absolutely fantastic; they always apologise when there are delays.”

• Managers used a ‘demand tool’ to identify when demand for transport was heaviest and made adjustments to the staff rota accordingly to meet this fluctuating demand.

• There were systems in place to audit the quality of responses to complaints and monitor all actions and trends.

• Staff told us how a recent operational restructure significantly improved operational systems and lines of communication.

• There was a staff incentive scheme which rewarded staff for performance in different areas.

• There were arrangements in place for identifying, recording and managing risks, issues and mitigating actions.

• An NHS commissioner told us that the provider demonstrated commitment to address performance related issues.

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

• Risk assessments were not in place to support the decision that a director post was not eligible for a DBS check.

• The current fleet whilst well maintained showed signs of wear.

• One vehicle had the appearance of a high dependency vehicle rather than a patient transport vehicle only.

• The provider was not meeting their key performance indicators for inward journeys completed between 50 minutes before and 20 minutes after the appointment time and outward journeys collected within 60 minutes of planned or booked time.

• Many complaints related to late pick-up either from home or the hospital.

• Aborted journeys accounted for almost 10% of all journeys. These are journeys which were abandoned en route either by the patient or the commissioner.

• There was a low response rate to the provider’s survey of patient experiences.

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 one requirement notice that affected the patient transport service. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (London), on behalf of the Chief Inspector of Hospitals