Central Ambulance Service Limited (Manchester)

Updated 6 October 2022

This is the first inspection for Unit 4 Cornishway Industrial Estate. The provider of the service is Central Ambulance Service Ltd. The service has a manager registered with the Care Quality Commission (CQC).

The service primarily provides a patient transport service. However, as part of the service, they provide event support that includes emergency care and transportation at high speed. This is regulated by CQC. They also provide first aid events and a repatriation service. CQC does not regulate repatriation and first aid only services. The service is staffed by a doctor, paramedics, nurses, emergency care assistants and ambulance care assistants.

The main service provided by this independent ambulance service was patient transport services. Where our findings on urgent and emergency care for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the patient transport service.

Updated 6 October 2022

This is the first inspection for the service We rated it as requires improvement because:

• Leaders did not have a clear understanding of the needs of the service and did not manage the issues the service faced. The service did not operate effective governance processes that monitored the quality of the care provided and had no process for quality and improvement. As a result, risks and performance were not managed effectively. There were no completed and updated risk assessments for each patient that removed or minimised risks. Staff were not trained in how to identify and act upon people at risk of deterioration.
• The service did not have a vision for what it wanted to achieve or a strategy to turn it into action, developed with all relevant stakeholders.
• The service did not control infection risk well. Clinical storage areas were not clean and control measures to protect people from potential infection were not in place. The design, maintenance and use of facilities, premises and equipment did not consistently keep people safe.
• The service did not consistently manage patient safety incidents well. The service did not consistently investigate incidents. Managers had limited arrangements to ensure that actions from patient safety alerts were implemented and monitored.
• The service did not have effective systems and processes in place to safely administer and store medicines.
• Robust arrangements to make sure all staff completed training and recruitment as needed were not in place. The service did not have robust arrangements in place to make sure staff were competent for their roles. Appraisals, inductions and supervision of staff were requested and not made available.

However:

• All those responsible for delivering care worked together as a team to benefit people. They supported each other to provide good care. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.
• Staff took account of people’s individual needs making reasonable adjustments to help them access the service. Staff treated people with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. They provided emotional support to people, families and carers to minimise their distress.
• The service planned and provided care in a way that met the needs of people and the communities served. The service had enough staff to provide support as requested. Managers reviewed and adjusted the staffing as needed.
• Staff understood how to protect people from abuse. All staff had relevant training in safeguarding adults and children.
• Staff kept equipment ambulances visibly clean and undertook deep cleaning as needed. Vehicles were checked to ensure they were safe to be used.
• Staff liked working for the service and enjoyed the work they did. Their morale had increased over recent months with staff reporting that they felt supported.

Updated 6 October 2022

This is the first inspection for the service We rated it as requires improvement because:

• Leaders did not have a clear understanding of the needs of the service and did not manage the issues the service faced. The service did not operate effective governance processes that monitored the quality of the care provided and had no process for quality and improvement. As a result, risks and performance were not managed effectively. There were no completed and updated risk assessments for each patient that removed or minimised risks.
• The service did not have a vision for what it wanted to achieve or a strategy to turn it into action, developed with all relevant stakeholders.
• The service did not control infection risk well. Clinical storage areas were not clean and control measures to protect people from potential infection were not in place. The design, maintenance and use of facilities, premises and equipment did not consistently keep people safe.
• The service did not consistently manage patient safety incidents well. The service did not consistently investigate incidents. Managers had limited arrangements to ensure that actions from patient safety alerts were implemented and monitored.
• The service did not have effective systems and processes in place to safely administer and store medicines.
• Robust arrangements to make sure all staff completed training and recruitment as needed were not in place. The service did not have robust arrangements in place to make sure staff were competent for their roles. Appraisals, inductions and supervision of staff were requested and not made available.

However:

• All those responsible for delivering care worked together as a team to benefit people. They supported each other to provide good care. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care.
• Staff took account of people’s individual needs making reasonable adjustments to help them access the service. Staff treated people with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. They provided emotional support to people, families and carers to minimise their distress.
• The service planned and provided care in a way that met the needs of people and the communities served. The service had enough staff to provide support as requested. Managers reviewed and adjusted the staffing as needed.
• Staff understood how to protect people from abuse. All staff had relevant training in safeguarding adults and children.
• Staff kept equipment ambulances visibly clean and undertook deep cleaning as needed. Vehicles were checked to ensure they were safe to be used.
• Staff liked working for the service and enjoyed the work they did. Their morale had increased over recent months with staff reporting that they felt supported.

Updated 6 October 2022

Findings are spread across both core services. See the overall summary in patient transport services for complete details.

This is the first inspection for the service. We rated it as requires improvement because:

Safe, well led and effective were rated requires improvement and caring and responsive were both good.