E-Zec Medical - Gloucester

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We reviewed the learning culture; safe systems; pathways and transitions; safeguarding; involving people to manage risks; safe environments; safe and effective staffing; infection prevention and control; and medicines optimisation. We reviewed the learning culture; safe systems; pathways and transitions; safeguarding; involving people to manage risks; safe environments; safe and effective staffing; infection prevention and control; and medicines optimisation quality statements for the safe key question. Staff followed corporate policies and process to provide safe care for patients. Staff reported concerns regarding patient or environmental safety, and shared learning following investigations of incidents and complaints. Managers arranged staffing for journeys and adjusted this according to demand for the service.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had appropriate corporate policies and local procedures to guide staff. Managers used processes to identify where the service could improve how it provided care. Staff and managers shared information with partner agencies and took action to improve the service. Staff knew how to report any concerns they had about the service. The complaints record tracked the stages of each complaint and actions identified to reduce a recurrence. This was shared at management meetings and learning cascaded to staff. In response to patient feedback, staff were able to offer refreshments to maintain hydration, for patients if journeys were unavoidably delayed.

Staff were encouraged to report incidents to managers and received feedback about actions taken. Managers created opportunities to encourage staff to contribute their ideas and communicate with managers. There had been a recent initiative where managers worked with staff to share skills and promote a culture of being one team. Learning was shared with staff at team meetings, in staff rooms and using email. We saw records of complaints which were investigated and learning identified to reduce a recurrence. Outcomes were shared with patients and families with an explanation of actions they were taking. Staff had a good understanding of the duty of candour and understood their responsibilities. The duty of candour requires registered providers and registered managers (known as ‘registered persons’) to act in an open and transparent way with people receiving care or treatment from them .

Staff used a booking system to capture individual patient needs and made any adjustments necessary to maintain patient safety. This included mobility needs, if they needed a chaperone and any infection control risks. Information was shared between the service, partner agencies, patients and their families to meet demand of patient journeys and maintain patient safety. Staff and managers monitored patient safety and reported any concerns.

Staff used defined processes to share information and assess patient needs. Digital systems supported information sharing and daily meetings identified where further reasonable adjustments to journey plans would improve patient experience. A patient transport liaison officer worked within a hospital team to manage issues and meet patient needs where possible.

Staff had completed safeguarding training in line with national guidance. Staff were trained in safeguarding level 2 for both adults, and children and young people safeguarding as a minimum. Training schedules showed staff had completed learning disability and autism training. The corporate safeguarding policy followed national guidelines. Recruitment processes included safeguarding checks using statutory DBS checks and these were monitored before work was allocated. This was an improvement since the inspection in 2023.

Staff received training specific for their role on how to recognise and report abuse. Staff in all areas had easy access to safeguarding information about how to refer and escalate concerns. Staff demonstrated a professional curiosity and escalated their concerns to protect patients from harm. Staff checked patients were in a safe environment before leaving. If they felt patients were not safe staff would return them to hospital and report the concern. We saw referrals staff had made which showed a genuine concern and understanding of where patients may be at risk.

Staff liaised with partner agencies to plan journeys according to patient needs. The patient transport liaison role had received positive feedback from partner agencies. The patient transport liaison officer worked as part of a hospital team to support the discharge of patients home or to a more suitable care option. The patient transport liaison officer met with patients and families to identify individual needs and provide suitable transport. They were also able to support when patients complained and assess where they could improve the service. We reviewed complaints for a 3 month period, which identified concerns about timing of journeys. Individuals who raised concerns had received responses from managers.

Staff and partner agencies used the booking processes to identify potential risks for patients and take action to reduce the risk. The service provided wheelchairs for patients with mobility problems which had been safety tested. Patients could use their own wheelchairs for the journey but only if they had also been safety tested. Patients were informed of this safety measure before their journey. If staff felt the service could not safely accommodate patient needs they informed partner agencies, patients or families that alternative arrangements needed to be made.

Managers monitored staff compliance with corporate policies. Cleaning schedules documented when deep cleans had been performed and when they were next due for each vehicle. Roadworthiness of vehicles was monitored and mechanical checks using a certified garage ensured vehicle safety. Staff reported defects between these checks and actions were taken to rectify them.

Staff had access to suitable equipment to carry out their role. They carried out daily safety checks and we saw these were completed consistently. The service had suitable facilities and equipment to safely meet the needs of patients and their families.

Vehicles, equipment and storage facilities were maintained in a way to reduce risk to patients. Areas we visited appeared clean and well organised. Staff carried out daily checks on vehicles and equipment to ensure they were suitably maintained and clean. Vehicles contained appropriate equipment to keep patients safe during a journey including harnesses and wheelchair securing points.

Staff undertook skills training for their roles and managers monitored staff compliance. Where staff were due to update training managers acted to remind staff. Driving competency was assessed before staff drove a vehicle and newly recruited staff were required to complete an induction programme. Managers monitored training and carried out appraisals with staff to identify where and how to support staff. Records showed staff were compliant with training.

Managers allocated staff to vehicles for shifts. Managers used processes to allocate additional staff where there were gaps in rotas or demand for the service had increased. Governance meetings monitored staff compliance with training for their roles.

Survey results collected by the service showed patients felt staff had the skills and ability to provide care during the journey. Patients felt staff treated them with dignity and respect and all were satisfied with the standard of driving.

Staff followed corporate infection prevention and control policies. Managers monitored staff compliance and effectiveness of cleaning using audit processes. Records showed vehicles were up to date with scheduled deep cleaning and where action was needed to improve staff compliance.

We reviewed vehicles and equipment between journeys although we did not observe any journeys. Vehicles and equipment were clean and ready for use. Personal protective equipment was readily available for staff to use. There was a log of equipment cleaning and maintenance for reference.

Staff completed checks of vehicles before and after each journey to ensure they were clean and personal protective equipment was available. Staff could perform or request additional cleaning between scheduled cleaning if there was a risk of cross contamination following a journey.

Staff did not administer medicines to patients during journeys. The service had an agreement with commissioners to provide oxygen for patients who needed it during the journey with defined boundaries. The oxygen had to be prescribed before the journey and administration was limited to 28%. Oxygen cylinders were checked and empty cylinders replaced using an agreement with a supplier.

Oxygen cylinders were stored safely, in date and available for patient use.