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

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 6 February 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.

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:

• Staff were committed to providing the best quality care to patients. Staff displayed a caring and compassionate attitude and took pride in the service they were providing.

• Staff operated comprehensive systems to make sure that all vehicles, equipment and medicines were safely managed and fit for purpose.

• Vehicles and stations were visibly clean and tidy, with evidence of regular deep cleaning of vehicles.

• The provider had developed systems to accurately monitor whether all staff had the qualification and skills needed to provide high-quality care.

• Relevant background checks had been carried out during recruitment processes. This included, for example, a full Disclosure and Barring Service (DBS) and a driving license check.

• We observed good multidisciplinary working between crews and other NHS staff when moving patients.

• The management team worked with local NHS providers to supply services which met the needs of local people.

• Staff were well supported by the management team; they told us the management team were friendly and approachable.

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

• Staff completed a self-assessment in relation to their physical health during the recruitment process. This included a request in relation to their routine immunisation history. However, the provider did not currently check that relevant staff had been immunised with other selected vaccines, such as Hepatitis B, which may be appropriate for their role.

• There were currently no arrangements for ongoing, practical checks of driver competence beyond a periodic review of the validity of each staff member’s driving license.

• The information received during the online booking procedures was not always sufficient for staff to inform themselves about the potential risks associated with transporting individual patients. Staff did not routinely keep an accurate, complete and contemporaneous record of the care and treatment provided to each patient.

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 services. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North of England), on behalf of the Chief Inspector of Hospitals

During our previous visit we made a judgement of non- compliance in relation to records. This was because the records available to us at that time failed to demonstrate that appropriate recruitment documentation had been obtained.

During this visit we saw that improvements had been made by the organisation to ensure that senior staff within the Warrington based service had access to recruitment documentation.

Medical Services Ltd (Warrington) provides services throughout the North West and beyond. Vehicles available within the service include high dependency equipped ambulances and other vehicles that are able to transport people by stretcher and users of wheelchairs.

We were not able to speak to people who used the service as it does not support a regular core of individuals. However, we did speak with representatives of three National Health Service provisions who used the service on a regular basis. All three representatives told us positive things about the service Medical Services Ltd (Warrington) provided to patients. Their comments included the “drivers are very good”; “they provide a good service”; “very responsive service” and “staff are really professional and get on well with other staff.”

We saw that systems were in place to plan and record patient information. Policies and procedures were in place to help maintain the health and safety of both patients and staff.

Improvements are required in relation to the obtaining and maintenance of records in relation to the recruitment of staff.

On this occasion we did not speak to people about the service. This service does not provide support to a regular core of individuals who we could refer to.