St John Ambulance - South Region

We rated well led as requires improvement. We assessed 5 quality statements on leadership, freedom to speak up and governance. Local leaders understood the challenges faced by the service but were not always visible or accessible to staff. Local leaders had the knowledge and skills however changes to the providers leadership team during the assessment period September 2023 to July 2024 created a period of instability. The service lacked a shared direction and there was a negative culture amongst staff. Services were not sustainable because of reduced NHS contracts and heavy reliance of volunteer staff. There were clear governance systems, but we found out of date policies, lack on systematic audits, lack of staff appraisals and there were sustainability risks to the service. Staff were not confident to speak up and reported bullying and poor incident reporting to the CQC. However, the service worked well with a third party organisations to repatriate adults and children to various hospitals across the patch although staff told us that staffing levels were at times reduced.