Archived: Abacus Ambulance Service

Updated 21 July 2017

Abacus Ambulance Service is operated by Abacus Ambulance Service. The service provides both patient transport services (PTS) and emergency transport for high dependency transfers.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of our inspection on 7 March 2017, along with unannounced visits to the base location on 20 March 2017 and 3 April 2017.

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 was patient transport services, with a small proportion of work carrying out urgent care and emergency transport services.

Updated 21 July 2017

Abacus Ambulance Service is operated by Abacus Ambulance Service. The service provides both patient transport services (PTS) and emergency transport for high dependency transfers.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of our inspection on 7 March 2017, along with unannounced visits to the base location on 20 March 2017 and 3 April 2017.

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 was patient transport services, with a small proportion of work carrying out urgent care and emergency transport services.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

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

• The service had no formal incident reporting policy in place. There was no formal sharing of lessons learnt as a result of incidents. Staff had not received training in incident reporting.

• Staff were unaware of the duty of candour and had not received training in this at the time of our inspection.

• There was a lack of deep cleaning processes in place to prevent the spread of infection. The infection prevention and control policy, put in place after our announced inspection on 7 March 2017, lacked key information and guidance.

• The safeguarding adults and children lead had not received the appropriate level of safeguarding training as recommended in best practice guidelines.

• We found faulty equipment in vehicles, which posed a risk to staff and patients. Equipment was not securely stored during transportation.

• Patient report forms lacked pertinent patient information. A patient report form records all patient information relevant to medical conditions, for example, personal information and observations. We were not assured that patient report forms accurately reflected a patient’s condition or any care that may have been given.

• We were unable to gain assurances that staff had received the necessary mandatory training to carry out their role safely and effectively.

• There was no inclusion or exclusion criteria in place. We were not assured that the booking process adequately assessed a patient and their clinical needs due to the limited amount of information taken at the point of booking.

• There was a lack of competency oversight for ambulance paramedic and technician staff when used for high dependency transfers.

• The service had weak governance systems and poor oversight of risk. Policies lacked reference to national guidelines. Monthly governance meetings lacked clear agendas and no discussion around risk took place.

• There was a lack of regular and documented staff engagement. Staff did not have regular planned appraisals and one to one meetings were informal and not documented.

However, we found the following areas of good practice:

• Staff were able to clearly articulate what constituted an incident despite a lack of formal training.

• Staff were able to explain what constituted a safeguarding concern.

• Vehicles contained personal protective equipment for staff.

• All vehicles had received regular MOT and servicing. The service was meeting the nutritional and hydration needs of patients.

• Patient feedback was consistently positive.

• The service was planned and delivered to meet the needs of local people.

• Staff described management as approachable and supportive. They reported feeling valued in their role.

We highlighted our findings and concerns to the registered manager over the course of the announced inspection and two subsequent unannounced inspections.

We found the provider to be in breach of several regulations of the Health and Social Care Act 2008 Regulated Activities regulations (2014), inclusive of regulation 12 (safe care and treatment), regulation 13 (safeguarding service users from abuse and improper treatment), regulation 15 (premises and equipment) and regulation 17 (good governance).

Following our unannounced inspection on 20 March 2017, the service voluntarily suspended all high dependency transfers that required paramedic and ambulance technician skills. After our second unannounced inspection, on 3 April 2017, the service voluntarily suspended all patient transport services. On 2 May 2017, the service recommenced work for patient transport service journeys only. The ambulance fleet had reduced in number from eight vehicles, to four vehicles.

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. The provider was in breach of regulations and submitted a statutory notification after our unannounced inspections to suspend all patient transport services.

Professor Ted Baker

Deputy Chief Inspector of Hospitals

Updated 21 July 2017

Overall we have not rated patient transport services (PTS) at Abacus Ambulance Service because we were not committed to rating independent providers of ambulance services at the time of this inspection.

Patient transport services were the main activity of the service, with the service carrying out a small number of high dependency transfers.

The service was in breach of several regulations of the Health and Social Care Act 2008 Registration regulations (2014), such as regulation 12 (safe care and treatment), regulation 13 (safeguarding service users from abuse and improper treatment), regulation 15 (premises and equipment) and regulation 17 (good governance).

The service suspended their services after our unannounced inspections.