Air Ambulance Operations Headquarters is operated by Kent, Surrey & Sussex Air Ambulance Trust. The service provides emergency and urgent care. A team of doctors and paramedics deliver time-critical medical care. Clinical staff respond to patients predominately by helicopter but also use a response vehicle in the event the crew cannot respond by air.
We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 16, 17 January 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.
We have not previously rated this service. We rated it as Outstanding overall.
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The service provided mandatory training in key skills to all staff and made sure everyone completed it.
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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. Staff and managers worked together with external stakeholders to safeguard their patients.
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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.
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The design, maintenance and use of facilities, premises, vehicles and equipment was innovative and kept people safe. Staff were trained to use them. Staff managed clinical waste well.
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People were protected by a strong comprehensive safety system, and a focus on openness, transparency and learning. A proactive approach to anticipating and managing risks to people who used services was recognised as being the responsibility of all staff. Staff identified and quickly acted upon patients at risk of deterioration. External organisations were actively engaged in assessing and managing anticipated future risks.
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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. Managers regularly reviewed and adjusted staffing levels and skill mix and gave bank staff a full induction.
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Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date, and stored securely. They had innovative ways to make patient information more easily available to all staff providing care.
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The service used strong comprehensive systems and processes to safely prescribe, administer, record and store medicines. The service took a proactive approach to improving their medication safety.
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There was a genuinely open culture in which all safety concerns raised by staff and people who use the service were highly valued as integral to learning and improvement. All staff were open and transparent, fully committed to reporting incidents and near misses. The level and quality of incident reporting showed the levels of harm and near misses, which ensured a robust picture of quality. There was ongoing, consistent progress towards safety goals reflected in a zero-harm culture. Learning was based on a thorough analysis and investigation of things that went wrong.
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There was a truly holistic approach to assessing, planning and delivering care and treatment to people who used the service. There was a safe use of innovative and pioneering approaches to care. New evidence-based techniques and technologies were used to support the delivery of high-quality care.
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Staff assessed and monitored patients regularly to see if they were in pain and gave pain relief in a timely way. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.
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All staff were actively engaged in activities to monitor and improve quality and outcomes. Opportunities to participate in benchmarking, peer review, accreditation and research were proactively pursued. High performance was recognised by credible external bodies.
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The continuing development of staff skills, competence and knowledge was recognised as being integral to ensuring high quality care. Staff were proactively supported to acquire new skills and share best practice.
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Staff, teams and services were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care to people who use services.
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Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health.
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People were truly respected and valued as individuals. Feedback from people who use the service and those who were close to them was continually positive about the way staff treat people. People thought that staff went the extra mile and the care they received exceeded their expectations. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
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People’s emotional and social needs were highly valued by staff and were embedded in their care and treatment. Staff provided emotional support to patients, families and carers to minimise their distress.
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People who use services were active partners in their care. Staff were fully committed to working in partnership with people. Staff always empowered people who use the service to have a voice and to realise their potential. Staff highly valued the patient’s relatives and those close to them.
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The involvement of other organisations and the local community was integral to how services were planned and ensured services met the needs of local people and the communities served.
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People’s individual needs and preferences were central to the planning and delivery of tailored services. The service made reasonable adjustments to help patients access services.
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People could access the service when they needed it and received the right care in a timely way. The service had developed innovative ways to improve the access people had to the service.
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It was easy for people to give feedback and raise concerns about care received. There were active reviews of complaints and how they were managed and responded to, and improvements were made as a result across the services.
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Leaders had an inspiring shared purpose, strove to deliver and motivate staff to succeed. Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.
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The service had a vision for what it wanted to achieve and a strategy to turn it into action, developed with all relevant stakeholders. The strategy and supporting objectives were stretching, challenging and innovative while remaining achievable. These were aligned to local plans within the wider health economy. Leaders and staff understood and knew how to apply them and monitor progress.
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There was a strong culture that was centred on the needs of patients. Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values to deliver high quality person-centred care. The service provided opportunities for career development and staff could raise concerns without fear. Staff were proud of the organisation as a place to work and spoke highly of the culture.
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Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.
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Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events.
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The service collected a wide range of reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required.
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Leaders and staff used innovative approaches to gather feedback from people who used services and the public. This was then used to plan and manage services. They collaborated with local, national, international partner organisations to help improve services for patients. There were consistently high levels of constructive engagement with staff.
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All staff were committed to continually learning and improving services. The leadership drove continuous improvement and staff were accountable for delivering change. Safe innovation was celebrated. There was a clear proactive approach to seeking out and embedding new and more sustainable models of care. Leaders encouraged innovation and participation in research.