- Ambulance service
E-Zec Medical - Gloucester
All Inspections
22 & 27 March 2023
During a routine inspection
We carried out a comprehensive inspection of E Zec Medical - Gloucester, as part of our inspection programme. We inspected all of our key questions: safe, effective, caring, responsive and well led.
They were last inspected in April 2021 but were not rated as Care Quality Commission did not have the legal powers at that time to rate independent ambulance services. This was a focused inspection and we looked at safe and well led. They were issued with 3 requirement notices, 1 was for premises and equipment, 1 for governance arrangements and the other for fit and proper persons. We found at this inspection the service had made improvements to meet those requirement notices.
This is E Zec Medical Gloucester first comprehensive inspection.
Before the inspection we reviewed information, we had about the provider, including information we had received and intelligence available.
We rated E Zec Medical Gloucester as requires improvement because:
- Whilst all vehicles were scheduled for a deep clean frequently, we found some vehicles had areas that had been missed during cleaning, and this had not been identified from quality checks. Information that could identify a patient had been left in a vehicle for some time and this had also not been identified on the quality checks.
- Not all staff had received their appraisals, but senior staff were working on a plan to address this
- Some patients were having to wait for transport, or it had been cancelled at the last minutes and some key performance indicators were not being met.
- There had been improvements with the recruitment practices of new staff, but systems and processes to check staff had a full employment history with gaps explored was not effective.
However:
- 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. The service managed safety incidents well and learned lessons from them.
- Staff provided good care. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients. 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. They provided emotional support to patients.
- 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 mostly 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. Most 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 commissioners to plan and manage services and all staff were committed to improving services.
- Disclosing and Barring checks (DBS) were routinely re-checked every 3 years for operational staff.
7 April 2021
During an inspection looking at part of the service
We carried out a focused inspection of E Zec Medical Gloucester on 7 April 2021, due to concerns about another location managed by this provider. As this was a focused inspection, we only inspected parts of our key questions: safe and well led. We did not inspect effective, caring or responsive. This is the first inspection for this service since it was registered with the Care Quality Commission in December 2019. Before the inspection we reviewed information we had about the provider, including information we had received and intelligence available.
The inspection had a short announcement (24 hours) to enable us to observe routine activity. Due to the narrow focus of this inspection, we did not rate this service at this inspection.
We found;
- Equipment was left on patient transport vehicles that was not required, and staff were not trained in their use. Some vehicles were being used when they had been identified as having maintenance issues. This was not safe practice.
- Governance systems used to monitor the quality of the service did not always identify shortfalls in service provision. The recruitment process did not ensure that safety checks about new staff were used to protect patients. Senior depot staff were not always made aware of any staff risks needed to ensure patient safety.
However:
- The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
- Services were run using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients using their service. Staff were clear about their roles and accountabilities.