Transcare Services (UK) Limited is an independent ambulance service provider based in Keighley, West Yorkshire. The service is registered to provide patient transport services. Transcare Services UK Ltd offers ambulance transport on an ‘as required’ basis and provides pre-planned transport. Ambulance services are provided to an NHS trust and an ambulance service trust.

We inspected this service using our comprehensive inspection methodology. We carried out a scheduled comprehensive inspection on 20 February 2018. The service had one registered base which we inspected.

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 patient transport.

Services we do not rate

We regulate independent ambulance services, but at the time of the inspection we did not 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 knowledgeable about how to report incidents to ensure the safety of people using the service.

• The service ensured a minimum of two staff were allocated to each patient transfer depending on risk and need. The staffing levels and skill mix of the staff met the patients’ needs.

• Systems were in place to ensure vehicles were well maintained. Staff maintained consumables and stock to ensure stock was in date and fit for purpose.

• All equipment necessary to meet the various needs of patients was available.

• Services were planned and delivered in a way that met the needs of the local population. The service took into account the needs of different people, such as bariatric patients or people whose first language was not English. Journeys were planned based upon their requirements.

• We observed appropriate hand hygiene, and infection control processes.

• The service had a system for handling, managing and monitoring complaints and concerns.

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

• Staff were not up to date with training in duty of candour, safeguarding and infection control to ensure they were safe to carry out the duties they were employed to perform.

• Deep cleaning records were not provided and audits did not take place. The provider needed to ensure the patient transport drivers had the correct cleaning equipment at home and were following the correct infection control processes when deep cleaning their vehicle at their residential address.

• A vision and strategy for the service had not been developed.

• Team meetings did not regularly take place.

• Appraisals did not take place.

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 four requirement notices that affected patient transport services. Details of these are at the end of the report.

Ellen Armistead

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

We found that the provider had processes in place that ensured staff treated people with respect and we found the service had a person-centred approach. We found staff had appropriate knowledge of the people they provided transport for and understood known risks.

We found the provider had processes in place that ensured that ambulances were clean and fit for purpose and ambulance staff had a sufficient knowledge of infection prevention and control. We also found there were appropriate processes in place for the recruitment of ambulance staff that ensured people were of good character and able to carry out the work safely and effectively.

We found there was an effective complaints procedure and we saw an example where the procedure had been followed through as set out in the complaints policy.

We spoke with a member of staff at a hospital where staff knew some of the ambulance staff; they confirmed that they were polite and respectful. They also said ambulance staff always ensured people were safe and secure before leaving them at their destination.