Bristol Ambulance Emergency Medical Services (EMS) is operated by BAEMS Limited. The service provides emergency and urgent care and a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 20 and 21 February 2018, along with a further visit to the ambulance base on 21 June 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.

The main service provided by this service was emergency and urgent care. Where our findings on emergency and urgent care – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the main service core service.

Services we do not rate

We regulate independent ambulance services and at the time of this inspection we did not currently have a legal duty to rate them. We highlight good practice and issues service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• There were strong, thorough and embedded systems, processes and procedures to keep people safe.
• There were reliable systems to monitor and maintain standards of cleanliness and hygiene which was well documented.
• The environment was secure and suitable for safe storage of ambulances and equipment.
• There were comprehensive governance arrangements, which allowed the organisation to work in line with best practice and deliver high quality care. Patient care was at the centre of everything the organisation and staff did.
• Frontline staff and senior managers were passionate about providing a high-quality service for patients with a continual drive to improve the delivery of care.
• There was excellent local leadership of the organisation. The registered manager had an inspiring shared purpose and was committed to the patients who used the organisation, as well as to staff.

However,

• The service was unable to provide evidence of the administration of medicines being recorded appropriately as patient clinical records were returned to the contracting trust.
• The service did not monitor response times and patient outcomes.
• The patient transport service did not have access to translation services, family escorts usually travelled with the patient to act as the translator.

Nigel Acheson

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