Elite Medical and Ambulance Service Ltd (Elite) is operated by Elite Medical and Ambulance Service Limited. The service provides a patient transport service.

We inspected this service using our comprehensive inspection methodology in response to concerns raised by whistle-blowers. We carried out an unannounced inspection on 30 January 2019.

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.

We found the following areas of good practice:

• The provider had recently changed their process for reviewing incidents, and all incidents were now reviewed by the registered manager, as well as being reviewed by the contracting NHS ambulance service.

• Staff had training to the correct levels of safeguarding in line with best practice and national guidance. Staff understood their responsibilities in the event of identifying concerns.

• All the vehicles we looked at appeared visibly clean and tidy. All vehicles had a MOT and tax certificate and were free of any obvious damage and defects such as dents and worn tyres.

• Patient data was securely held by the contracting provider, and Elite staff could access the information they needed to complete their transfers through their secure personal digital assistants.

• Feedback from users of the service was positive.

• There were processes in place to ensure the needs of individuals were met.

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

• Not all staff had completed their mandatory training modules and only 20% of staff had completed their medical gases training.

• The service’s safeguarding policies for adults and children did not reflect the process that staff followed when identifying a safeguarding concern. Systems and processes were not in place to ensure data and notifications were submitted to external bodies as required. The service was not meeting its’ statutory obligation for notifying the CQC of safeguarding concerns. However, following the inspection, the service submitted notifications to the CQC and were in the process of updating their policy to reflect this.

• There was business continuity plan however this had some gaps where further information was required. The registered manager could describe practical steps taken in situations such as inclement weather.

• Less than 10% of staff had an appraisal within the last 12 months.

• Some policies including the safeguarding policy did not contain the most up to date guidance or best practice.

• There was an induction process for new staff, but there were no signed induction forms or checklists, in the staff files that we reviewed, to confirm that inductions were carried-out.

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 two requirement notice(s) that affected patient transport services. Details are at the end of the report.

Dr Nigel Acheson

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