Role 1 Medical Ivybridge Station

Updated 1 June 2022

Role 1 Medical Ltd was registered in 2019. Ivybridge Ambulance Station is the location for the management of the regulated activity. Role 1 Medical provides hospital transfers, non-emergency patient transport for all age groups and emergency and urgent care contracted to a local NHS ambulance trust and a Clinical Commissioning Group. The provider works across Devon and Cornwall, going further afield when required. This report concerns the emergency and urgent care element of the provider. Patient transport has a separate report.

This is the first inspection of this service since registration in 2019. The main service provided is the emergency and urgent care component which provides 90% of the regulated activity. The service provided 2806 emergency journeys from July 2021 to February 2022 for all age groups of the local population. The provider currently has 4 ambulance cars and 13 ambulances.

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? We did not inspect the caring domain due to the nature of the emergency work it was not felt appropriate.

The provider is registered to provide the following regulated activity:

• Treatment of disease, disorder or injury
• Transport services, triage and medical advice provided remotely

The location has a registered manager in post since 2019. Registered managers have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

The provider employs 38 permanent and 15 bank members of staff.

We inspected this service using our comprehensive inspection methodology. We carried out the short notice announced inspection on 30 March 2022.

Updated 1 June 2022

We rated it as good because:

• The service had enough staff to care for patients and keep them safe. People are protected by a strong comprehensive safety system and a focus on openness, transparency and learning. 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 good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment and gave patients pain relief when they needed it. The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and had access to good information.
• The service planned care to meet the needs of local people, took account of patients’ individual needs. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the commissioners to plan and manage services and all staff were committed to improving services continually.

However:

• They did not manage medical gasses well. There were no proper storage facilities for medical gases, and they were not secure. There was no policy to manage medical gases.
• There were patient group directions for all the medicines to be administered but were not completed to the proper standard.
• Records relating to people employed must include information relevant to their employment in the role including information relating to the requirements. This applies to all staff, not just newly appointed staff.

Updated 1 June 2022

We had not rated this service before. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. People are protected by a strong comprehensive safety system and a focus on openness, transparency and learning. 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 good care records. The service managed safety incidents well and learned lessons from them.
• The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and had access to good information.
• The service planned care to meet the needs of local people, took account of patients’ individual needs. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the commissioners to plan and manage services and all staff were committed to improving services continually.

However:

• The provider needs a stronger process to report on performance.
• The provider does not have communication aids/pictures in all vehicles.
• The provider does not have any complaints/compliments leaflets for patients in the vehicles.

We rated this service as good because it was safe, effective, responsive and well led.

Updated 1 June 2022

This service has not been previously rated. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. People are protected by a strong comprehensive safety system and a focus on openness, transparency and learning. 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 good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment and gave patients pain relief when they needed it. The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and had access to good information.
• The service planned care to meet the needs of local people, took account of patients’ individual needs. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the commissioners to plan and manage services and all staff were committed to improving services continually.

However:

• There were no suitable storage facilities for medical gases. The gases were not securely stored as they were kept in an old ambulance that was no longer in service. There was no signage on the unit to indicate it contained medical gases. There was no policy to manage medical gases. The provider rectified this immediately. Patient group directions were not completed correctly. The provider rectified this immediately. Not all staff understood Gillick Competency. The provider rectified this immediately.
• There were no communication aids/pictures in the vehicles. The provider should complete appraisals for staff yearly.
• The records relating to people employed did not all contain information relating to the requirements under Schedule 3. The provider rectified this immediately.

We rated this service as good because it was safe, effective, responsive and well led.