16 and 29 March 2017
During a routine inspection
Surrey Ambulance Services is operated by Sites Ambulance Service Limited. The company is contracted to provide emergency and urgent care support to two NHS ambulance trusts along with a patient transport service. We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 16 March 2017, along with an unannounced visit to the service on 29 March 2017.
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 provider was urgent and emergency care (frontline support). Where our findings on the patient transport service also applies, we do not repeat the information but cross-refer to the urgent and emergency care core service.
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. In this case, we found no major issues of concern. After our inspection, we concluded the company provided a safe and effective service to the commissioning trusts and we observed several areas of good practice:
- Effective fleet management and vehicle clean and make ready processes.
- Medicine management, particularly controlled drugs, was safe and effective.
- Development and competency of staff was well managed.
- Multidisciplinary working with NHS trusts worked well.
- Patient assessment and interaction showed individualised patient care that took into account physical, emotional and capacity needs of the patient and relatives.
- Lessons learnt and action taken in response to any feedback and complaints worked well.
- All crews carried multilingual phrase books to assist communicating with those patients that did not speak English as their first language.
- The SAS had a duty officer system that operated 24 hours day and rotated between senior managers, fleet supervisors, the registered manager and clinical lead.
- Senior staff were visible with frequent interactions with colleagues and were readily available.The managing director would go on the road either as an observer, trainer or as a crew member.
- There was strong performance management demonstrating that leaders were proactive.
- There were robust performance management processes for both self-employed workers as well as those that had permanent contracts.
However, we also found the following issues that the service provider should improve:
- The provider should take action to ensure the risk register details risks to the organisation rather than reacting to problems that have arisen.
- The provider should improve the clarity in appraisal reporting lines.
- SAS should ensure all clinical waste bins are secured and not accessible to the general public.
- SAS should take steps to remove any ‘blacked out’ windows in ambulances and replace with tinted windows.
- SAS should ensure that all vehicle have functioning rear-cabin CCTV.