30 April 2019
During a routine inspection
SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG) . The service provides a patient transport service for patients with mental ill health.
We inspected this service using our comprehensive inspection methodology. We made an unannounced visit to the service on 30 April 2019.
The service had been previously inspected in April 2018 but not rated.
Following that inspection, we told the provider that it must take three actions to comply with the regulations and that it should make six other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected Patient Transport.
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.
We rated it as requires improvement overall.
We found the following issues that the service provider needs to improve:
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During the previous inspection the provider was given six should do actions to improve the service. During this inspection we found four of the six should do actions had not been completed.
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The provider did not have their own procedure for identifying high risk/infectious patients.
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During the inspection we found limited evidence the provider carried out effective audits to measure the quality and effectiveness of the service delivered. This was because the number of observations or gathering of audit information was so low; they were not a representative sample of the number of staff employed or the number of patient transports undertaken.
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The provider did not actively seek feedback about the quality of care and overall service provided.
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There was no evidence that dynamic risk assessments in relation to patients were recorded.
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There was not a system to record or measure the levels of staff adherence to local policies and procedures.
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There were very limited supervisory operational observations of staff carried out to identify either good or poor practice.
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During this inspection there was no evidence the PTS vehicles we inspected carried any information or leaflets which would explain to a patient, relative or carer how to make a complaint.
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During the inspection we did not see evidence of an effective system to actively seek feedback from patients, those lawfully acting on their behalf, their carers and others such as staff or other relevant bodies.
However, we found the following areas of good practice:
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During this inspection we saw evidence the provider had acted to deal with the three must do actions, two of the six should do actions and the requirement notice issued following the previous inspection.
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There was evidence of a formal system for reporting and responding to incidents.
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There were high levels of staff statutory and mandatory training.
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The station and working environment were visibly clean, safe and fit for purpose.
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There was evidence during this inspection that the five employed staff had a current appraisal.
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Staff observed during inspection displaying a caring, empathetic and supportive attitude.
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Staff were observed working well with hospital staff to calm a patient who was refusing to be transported.
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Patient transport journeys were planned to take account of patient risk.
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There was a shift system to manage access and flow covering 24 hours per day.
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There was evidence of a provider mission statement, values and strategic priorities for 2019.
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There was evidence of recent 1:1 staff employment consultation in relation to increasing the number employed staff in the company.
Following this inspection, we told the provider that it must take six actions to comply with the regulations and that it should make 12 other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected Patient Transport Services. Details are at the end of the report.
Ann Ford Deputy Chief Inspector of Hospitals (North), on behalf of the Chief Inspector of Hospitals