The Care Quality Commission
  • Ambulance service

Phoenix Private Ambulance Service

Overall: Requires improvement read more about inspection ratings

26 Dodd Avenue, Warwick, Warwickshire, CV34 6QS (01926) 403359

Provided and run by:
Castlebrand Limited

All Inspections

22 October 2021

During a routine inspection

Our rating of this location went down. We rated it as requires improvement because:

  • The service could not provide assurance that infection risks were controlled well through consistent standards of cleanliness.
  • Not all risk to patients or staff were controlled or assessed.
  • Senior staff did not adhere to the provider’s safe recruitment policy. The policy reflected national standards but was not consistently followed.
  • Safety arrangements in the garage used to stored and dispatch vehicles did not reflect safe practice or the provider’s policies.
  • Staff did not collect safety information or monitor performance and response times in order to improve the service.

However, we also found areas of good practice:

  • 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 managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care. Staff worked well together for the benefit of patients and supported them to make decisions about their care.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
  • Leaders supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients. Staff were clear about their roles and accountabilities. The service engaged well with patients and other providers to plan and manage services.

9 March 2020

During a routine inspection

Phoenix Private Ambulance Service is operated by Castlebrand Limited. The service provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the short notice announced inspection on 9 March 2020.

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 services.

Our rating of this service improved. We rated it as Good overall.

  • 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 good care records. They managed medicines well. The service knew how to manage safety incidents well. Staff collected safety information and used it to improve the service.

  • Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. 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 could access the service when they needed it and did not have to wait too long for a patient transport journey.

  • 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 community to plan and manage services and all staff were committed to improving services continually.

Heidi Smoult

Deputy Chief Inspector of Hospitals , on behalf of the Chief Inspector of Hospitals

18 December 2018 and 4 January 2019

During a routine inspection

Phoenix Private Ambulance Service is operated by Castle brand Limited and provides a patient transport service. This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

CQC regulates the patient transport service and treatment of disease, disorder and injury service provided by Phoenix Private Ambulance Service, which makes up over 50% of the business. The other services provided are not regulated by CQC as they do not fall into the CQC scope of regulation. The areas of Phoenix Private Ambulance service that we do not regulate are transporting of children to a place of education.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 18 December 2018 and then with a follow up inspection on the 4 January 2019.

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 found the following areas of good practice:

  • Staff know their responsibilities for reporting incidents.
  • Staff were up-to-date on mandatory training and there were systems in place to monitor staff compliance with mandatory training.
  • The service mostly had systems in place to maintain cleanliness of vehicles and equipment.
  • All staff cited that patient care was the most important part of the job.
  • A full verbal handover for all patients was given before any transport was undertaken and this was thoroughly checked as correct.
  • We witnessed very good care and excellent communication and manual handling skills by one crew on a transfer.
  • Premises and equipment were appropriate and well maintained.
  • Systems were in place to ensure ambulances were well maintained with equipment to meet the needs of patients.
  • The service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
  • Leadership was visible, responsive and staff could access them when required.

However, we found the following issues that the service provider needs to improve:

  • Governance systems were not established or effective. The service did not have an effective system in place to demonstrate risks had been identified and actions taken to mitigate risks, there was no formal process in place to report and record incidents, audits were not undertaken and some policies required updating.
  • Although staff were aware of how and when to report incidents, the service did not have a policy on incident reporting on the first day of inspection. When we returned on the 4 January 2019 a policy was being implemented and staff had been informed of the process, although this was not yet embedded.
  • Systems and processes were not in place to implement lone working procedures, although these were reviewed and added to the handbook immediately after the first day of inspection and were in place when we returned on the 4 January 2019.Staff were able to demonstrate their knowledge of the policy.
  • There was no clear written guidance on the patient criteria for transport, and although staff stated that they would not transfer an unstable patient, there was no written process in place to follow. This was duly reviewed and we viewed the written criteria on our return visit. However, this was not the final revision of the criteria, as there remained some criteria to be reviewed. Therefore, the new criteria policy was to be implemented by the end of January 2019.
  • There was no written criteria and process in place for the deteriorating patient. This was in the process of being added to the staff handbook and training at the time of the inspection in January 2019, but had not been fully embedded with staff.
  • The safeguarding training was found to be inadequate for the level required for the transport of adult patients.The management had implemented a training programme for all staff to have completed by the 15t January 2019.
  • Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with a requirement notice(s) that affected the transport service provided by them. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals on behalf of the Chief Inspector of Hospitals