MED-PTS Ambulance Services is operated by Mr Robert Willis. The service provides patient transport services (PTS) to local NHS trusts and provides privately funded PTS on request.

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

The main service provided by this service was PTS.

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 provider had no serious incidents or never events since registering with the commission.

• Staff knew about incident reporting, what would constitute an incident and how to report it but had never had to.

• Staff completed mandatory training on induction day and then two yearly. All five PTS staff (100%) had completed mandatory training.

• Staff knew how to recognise, and respond to signs of abuse, and report a safeguarding disclosure. All five staff (100%) had completed safeguarding adults and children level 2 training.

• The vehicles we inspected were visibly clean and fit for purpose. The provider had processes in place to clean, deep clean and monitor vehicle cleanliness and there was evidence of appropriate waste segregation.

• The provider had comprehensive policies and procedures in place; all had been reviewed within the review timescales and were available as electronic copies at the headquarters.

• The provider had competency assessments in place, which were regularly reviewed, to ensure staff were competent in their role.

• Staff completed training in dementia awareness, and how to effectively manage any challenging behaviours associated with patients living with dementia.

• Staff accessed translation services for those patients who did not speak English as a first language via an online application and carried picture prompt cards to support patients with communication difficulties

• The provider was beginning to monitor individual areas of performance, for example, waiting times at the point of patient collection from ward, vehicle cleanliness, and staff training and told us they would deal with any issues as they arose. The provider recognised the risks to the business, for example, the vehicles going off the road or the loss of business, and had carried out risk assessments of each risk and had plans in place to mitigate them.

• Staff described a positive working culture and a focus on team working, saying they could approach the manager or supervisor at any time to report concerns and got positive feedback when they had done a job well.

• The provider encouraged staff to seek feedback from patients. The feedback we reviewed was positive including comments about the professionalism of staff, and treating patients with dignity and respect. The provider had not received any complaints in the period between January 2017 and December 2017.

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

• The provider did not have a documented policy and procedure for staff to follow in the event of a deteriorating patient.

• Not all staff were familiar with the duty of candour regulation.

• The provider did not have documented eligibility criteria for patient transportation.

• The provider had some governance processes but had not yet fully embedded all governance processes such as auditing and team meetings.

• The provider did not undertake any benchmarking against other providers.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Heidi Smoult

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals