Ambulance & Medical Support Services - Ambulance Station Sandhurst

Updated 13 March 2020

Ambulance & Medical Support Services – Ambulance Station Sandhurst is operated by Ambulance & Medical Support Services Ltd. The service was registered with the Care Quality Commission (CQC) in May 2011. It is an independent ambulance service based in Sandhurst, Berkshire. The service primarily serves the communities of Berkshire and Hampshire but covers army boxing events in other counties.

Ambulance & Medical Support Services- Ambulance Station Sandhurst is not commissioned by other organisations to deliver services on a regular basis. Work was undertaken for event organisers and included conveying patients from event sites to NHS hospitals on an ad hoc basis. The service had three ambulances and five rapid response vehicles. We have only reported on the three ambulances as these were the vehicles used for the regulated activity.

The service for this location has had a registered manager in post since 08 September 2012. A registered manager is a person who has registered with CQC to manage a service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how a service is managed.

Updated 13 March 2020

We found the following issues that the service provider needs to improve:

The premises were not clutter-free and there had been no fire safety or environmental assessment completed for the premises.

Information contained in the service policies and procedures did not always match current working practices.

There were gaps in the service’s systems and processes that supported staff in assessing if a patient had the capacity to make decisions about their care.

The governance framework was still in its infancy, some aspects required further development and change needed to be embedded into the service.

However, we found the following areas of good practice:

The service provided mandatory training in key skills to all staff and made sure everyone completed it.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment, vehicles and premises visibly clean.

The service had suitable premises and equipment and mostly looked after them well. Staff managed clinical waste well.

Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.

The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment for events it was contracted to provide medical assistance for.

Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.

The service used systems and processes to safely prescribe, administer record and store medicines.

The service was beginning to manage patient safety incidents. Staff recognised incidents and near misses and were being encouraged to report them appropriately. Managers investigated incidents and shared lessons learned with the whole team. There was a Duty of Candour policy to follow if things went wrong.

The service provided care and treatment based on national guidance.

Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief advice in a timely way.

The service had started to monitor response times with the intention to use the findings to make improvements.

The service was putting in processes to monitor the effectiveness of care and treatment, with the intention of using the findings to make improvements and achieve good outcomes for patients.

The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and development.

Due to the nature of the service there was limited opportunities for staff to work with doctors, nurses and other healthcare professionals and support each other to provide good care.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.

The service planned and provided services in a way that met the needs of the event they were attending.

The service took account of patients’ individual needs.

People could access the service when they needed it and receive care in a timely way.

The service had systems and process in place for patients to give feedback and raise concerns about the care received. The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Although the manager at the service had the right qualifications to run a service, they had acknowledged they lacked the necessary skills, knowledge or experience to effectively manage and develop a service. They had taken the necessary steps to get support and bridge the gap whilst they developed their own skills. The manager was visible and approachable in the service for staff.

The service had a vision for what it wanted to achieve. The vision and strategy were focused on developing the quality and sustainability of the service and having the formal strategy to turn it into action.

There were indications that the service promoted a positive culture that supported and valued staff and were focused on the needs of the patients receiving care.

Systems and processes were being developed to operate an effective governance framework and to improve service quality and safeguard high standards of care.

Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.

The service had started to collect, analyse and use information to support activities.

The service was taking steps to improve engagement with patients, staff and the public.

Updated 13 March 2020

The service provides medical cover at events such as boxing (in support of army medical staff), motocross and equine events for adults and children. The service conveyed patients from event sites to the local acute NHS trusts.

We rated this service as good for safe and responsive and requires improvement for effective and well-led. We did not rate caring as we did not have enough evidence to make a judgement.

Improvements had been made to the service since we last inspected. Where knowledge and skills had been lacking in the service, advice and support had been sought and listened to. This had helped the service develop processes and systems to help improve service quality and keep patients safe from harm. However, change was in its infancy, some aspects required further development and changes needed to be embedded into the service.