St James Ambulance Service - St Albans

Updated 9 November 2022

St James Ambulance Service is an independent ambulance provider. It runs from the City of St Albans, Hertfordshire from a private address and provides non-emergency, community-based patient transport services for adults. The service does not transport children.

The service was commissioned by three NHS (National Health Service) hospital trusts in central and west London.

The service is registered with CQC (Care Quality Commission) for the regulated activity transport services, triage and medical advice provided remotely.

The service has had a registered manager in post since registration in 1999. This was the second inspection since registration, with the previous inspection completed in December 2017. We regulated independent ambulance services in 2017 but we did not have a legal duty to rate them.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 27 September 2022. To get to the heart of patients’ experiences of care, we ask the same five questions of all services: are they safe, effective, caring, responsive to people’s needs, and well-led.

Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate. Throughout the inspection, we took account of what staff told us and how the provider understood and complied with the Mental Capacity Act 2005.

Updated 9 November 2022

We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept safe care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided safe care by understanding patient needs in advance of journeys. Managers monitored response times and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care. The vehicles used had appropriate equipment, were up to date with service, MOT, and breakdown cover.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs. They provided emotional support to patients, families, and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People accessed the service when they needed it and did not have to wait too long to begin their journey.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. Staff were recruited in appropriate numbers with suitable employment checks.

However;

• Policies were not individually dated to provide assurances they were reviewed at regular intervals and in line with national guidance.
• Staff had access to safeguarding leads at the contracting provider, which was documented, however this was not clearly stated in an up-to-date safeguarding policy.
• One vehicle had a rip in the chair which did not meet appropriate infection prevention control standards. The registered manager remedied this immediately and ordered a replacement vehicle.

Updated 9 November 2022

We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept safe care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided safe care by understanding patient needs in advance of journeys. Managers monitored response times and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care. The vehicles used had appropriate equipment, were up to date with service, MOT, and breakdown cover.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs. They provided emotional support to patients, families, and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People accessed the service when they needed it and did not have to wait too long to begin their journey.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. Staff were recruited in appropriate numbers with suitable employment checks.

However;

• Policies were not individually dated to provide assurances they were reviewed at regular intervals and in line with national guidance.
• Staff had access to safeguarding leads at the contracting provider, which was documented, however this was not clearly stated in an up-to-date safeguarding policy.
• One vehicle had a rip in the chair which did not meet appropriate infection prevention control standards. The registered manager remedied this immediately and ordered a replacement vehicle.