First4care is a trading name of the registered provider F4Control Limited. F4Control Limited operates from a registered location in Edwinstowe, Nottinghamshire whilst providing patient transport services from a satellite location in Bourne, Lincolnshire. Patient transport services were provided under the trading names of ‘first4care’ and ‘Human Touch.’

F4Control Limited had undergone considerable managerial and operational change in the six months prior to our inspection. Applications were in progress to register Bourne as a location and to change the registered manager.

The regulated activity provided by F4Control Limited was patient transport services (PTS) utilising ambulances bearing the trading names of ‘first4care’ and ‘Human Touch.’

The inspection identified the service was also providing school transport out of the Edwinstowe location, under the trading name ‘first4care.’ Ambulances used for this service were not adapted to provide medical intervention and did not transport children to a medical facility. Therefore, this element of service was outside the scope of regulated activities.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 22 and 23 January 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.

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 service was responsive to differing levels of commissioned activity.
• Staff were committed to providing safe care to patients; this was reflected in patient feedback cards.
• Ambulances and equipment were well maintained and met infection prevention and control requirements.
• Staff were trained and assessed as competent to do their job.
• There was an incident reporting culture with sharing and learning actively encouraged.

• Managers were visible, approachable and expressed a pride in the staff.
• Managers were clear about the future of the business and shared their vision and strategy with all staff.
• The service was implementing an innovative approach to staff appraisal.

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

• Staff did not have clear guidance for the administration of oxygen.
• Staff were unsure who was their line manager.
• Policy documents did not consistently identify the trading names of the provider.

Following this inspection, we told the provider that it should take some actions to address the issues identified, even though a regulation had not been breached, to help the service improve. Following our inspection, we were provided with evidence to indicate all the identified issues were being addressed.

Heidi Smoult

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