Falck (Shropshire) is operated by Falck UK Ambulance Service Limited. The service provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 12 March 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.

The core service provided by this service was patient transport services.

This service was not previously rated however was previously inspected in 2017 under the name of Medical Services Ltd (Shropshire). We rated it as Good overall following the most recent inspection.

• The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.

• The service controlled infection risk well. Staff kept themselves, equipment and the premises clean.

• The service had suitable premises and equipment and looked after them well. The service followed best practice when giving and storing medicine which at this service was oxygen.

• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary. Staff kept records of patients’ care. Records were clear, up-to-date and easily available to all staff providing care.

• The service had enough staff with the right skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service made sure staff were competent for their roles.

• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents.

• The service provided care and treatment based on national guidance, policies and procedures. Managers monitored the response times of patient journeys and used the findings to improve them.

• The service accounted for individual health needs of patients and took these into account when planning journeys. Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.

• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Staff provided emotional support to patients to minimise their distress.

• Staff involved patients and those close to them in decisions about their care and treatment. The service took account of patients’ individual needs.

• People could access the service mostly when they needed it. The service monitored excessive waits for transport and acted to improve this.

• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

• Managers at all levels in the service had the right skills and abilities to run a service providing sustainable care. The service had a vision for what it wanted to achieve and workable plans to turn it into action. Staff were familiar with the values of the service.

• Culture had improved since our last inspection; management visibility was better, and staff reported enjoying their role.

• The service systematically improved service quality and safeguarded high standards of care. The service had good systems to identify risks, plan to eliminate or reduce them.

• The service engaged well with patients, staff and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively. The service was committed to improving services by learning from when things went well or wrong, promoting training and better ways of working.

  However, we also found:

• Feedback following the submission of incidents was not consistently provided to all staff.

• The service was not consistently meeting its key performance indicators, however, had plans and actions in place to improve results.

• Staff at times transported patients who had an active ‘do not attempt cardio pulmonary resuscitation’ order in place without carrying the correct paperwork.

• Not all vehicles had patient complaint leaflets on board.

• Whilst improvements had been made since our last inspection, some staff felt that leadership was still not visible enough. Staff did identify further areas of ongoing improvement to enhance their job role.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Please see ‘areas for improvement’ at the end of the report for details.

Amanda Stanford

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