SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG). The service provides a patient transport service (PTS) for patients with mental ill health. They also provide medical first aid support at public and private events.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 11 April 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 transporting patients with mental ill health.

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:

• Managers and operational staff were aware of the application of duty of candour and could give examples where it should be used, as well the requirement to be open and honest.
• There was detailed infection prevention and control (IPC) policy and staff were aware of their responsibilities in relation to this.
• PTS drivers had a current Business and Technology Education Council (BTEC) Level three advanced driver qualification and their eligibility to drive vehicles was checked prior to employment and on an ongoing basis.
• The staff mandatory training compliance rate at the time of the inspection was 87.5 %
• The provider`s policies were based on National Institute of Care and Excellence (NICE) Joint Royal Colleges Ambulance Liaison Committee (JRCALC) clinical practice guidelines.
• Staff could explain the implications of the Mental Capacity Act 2005 and Deprivation of Liberty Standards in relation to patient consent and to record any issues on the transport booking form.
• Staff could describe how they would take steps to try and minimise distress in patients and families.
• There was positive feedback from patients.
• Staff could outline how they would deal with patients with complex needs.
• Managers planned patient transport based on risk to ensure people’s individual needs were met.
• Regular monthly staff forum meetings were held where staff could raise issues.
• The provider had a well-managed extensive risk register.

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

• No staff appraisals had been completed since the company commenced providing PTS in July 2017, however, at the time of the inspection the provider was within the 12 month period for completing staff appraisals.
• The provider did not record any observation or audits of staff handwashing.
• The PTS ambulances did not carry any information regarding how a patient, carer or relative could make a complaint or provide feedback about the service.
• Dynamic risk assessments carried out by SSG staff in relation to handcuffing patients were not recorded.
• There was no site specific business continuity plan for the Cramlington building.
• The provider did not have a site specific risk register.

Following this inspection we identified one regulatory breach and six areas where the provider should improve, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ellen Armistead

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