NHS non-emergency patient transport services help people access healthcare in England. It is free at the point of use for people who meet certain medical criteria and are unable to use public or other transport.

In the South East, the patient transport service is managed by an NHS ambulance trust. To help meet demand for transport requests, the ambulance trust subcontracts to several independent providers, including Medi 4 ambulance services.

Findon Ambulance Station & Education Centre is operated by Medi 4 Ambulance Services Limited. The company provides a patient transport service from this location and a satellite base at Rowfant, near Crawley. In addition to the ambulance trust, Medi 4 has contracts to provide patient transport to an NHS hospital foundation trust and a clinical commissioning group.

We inspected this service using our comprehensive inspection methodology. We carried out this announced inspection on 18 April 2018. This is the service’s first inspection since registration.

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

In England, the law makes event organisers responsible for ensuring safety at their venue, which means event medical cover comes under the supervision of the Health & Safety Executive and not the care quality commission (CQC).

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.

The company also offers private ambulance transport and repatriation as well as event medical cover and first aid training. These last two activities are not regulated by the CQC and are not included in this report.

We found the following areas of good practice:

• The service acted to meet patients’ individual needs. This included patients for whom English was not a first language and patients living with dementia.
• All staff had undertaken ‘in house’ induction and mandatory training in key areas to provide them with the knowledge and skills they needed to do their jobs safely. The service provided accredited driver training for all clinical staff.
• All crew members completed regular continuing professional development to refresh their clinical skills and allow them to develop new ones. The service encouraged and supported personal development among all staff grades.
• The service controlled the risk of infection well. Staff kept equipment and the premises clean. All vehicles we inspected were visibly clean, and we saw evidence of deep-cleaning every eight weeks or sooner if needed. Staff demonstrated clear understanding of their daily duties in relation to cleanliness and infection prevention and control, in line with the provider’s infection prevention and control policy. Monthly audits provided assurance around standards of cleanliness.
• Staff understood how to protect patients from abuse and the service worked well with service commissioners to do so. All staff had training on how to recognise and report abuse and gave examples of times they had raised safeguarding concerns.
• Staff expressed pride in delivering compassionate care and treating patients with respect and dignity. We observed staff providing safe and effective care in all interactions with patients. Patient feedback we reviewed demonstrated a high level of patient satisfaction.
• Staff completed clear and thorough records of patients’ care and treatment. The service stored records securely to protect confidentiality. Monthly records audits provided ongoing assurance around clinical practice and standards of record keeping.
• The service had clear processes and systems to keep vehicles and equipment safe. This included annual MOTs, regular servicing and maintenance.
• All staff spoke highly of the local leadership and culture. The service took concerns seriously and acted to address them.
• The culture of the service encouraged openness and candour. Staff demonstrated a willingness to report incidents and raise concerns. Staff received feedback and any relevant additional training to ensure the service learned from incidents to improve patient safety.
• Managers and board members demonstrated an understanding of risks related to the service. We reviewed the risk register and board meeting minutes, which demonstrated ongoing oversight of quality and governance issues such as policies, risk management and human resources.

Amanda Stanford

Deputy Chief Inspector of Hospitals