Ambu Kare UK - Westwood Farm

Ambu Kare UK - Westwood Farm is operated by Ambu-Kare UK Ltd. The service provides a patient transport service to the local NHS hospitals and occasional private transfers.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on the 8 June 2017, along with an unannounced visit to the service on 26 June 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.

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 incident reporting process was not embedded and staff had not received any training on incident reporting, investigation or learning.
• The service did not have a formal inclusion or exclusion criteria to thoroughly assess if the patient was eligible to safely use the service.
• There was a lack of risk assessment performed and no specific risk assessment or policy for transferring children.
• Patient identifiable data was taken to the provider’s home address for transcribing which represented a data protection risk.
• The safeguarding adults and children lead had not received the level of training as recommended in best practice guidelines.
• There was a lack of oversight relating to the stocking and servicing of equipment.
• There was limited formal audit process in place to ensure all aspects of the service were continually monitored and the service did not benchmark itself against other providers either locally or nationally.
• There were guidance policies in place but they lacked version control and implementation and review dates. We were not assured all policies were in line with current guidelines or best practice.
• Staff were not knowledgeable about policies available for them to reference and there was no process to ensure that staff were up to date with current policies.
• The governance systems were weak and ineffective which meant that we were not assured that concerns would be identified and mitigated.
• The operational manager lacked clinical governance experience. This was reflected in the poorly adapted and out of date policies, and the lack of understanding of the need to measure quality and performance.
• The service risk register was in its infancy and there was a lack of understanding about what constituted a service risk.
• However, we also found the following areas of good practice:
• All staff had completed mandatory training within the last 12 months.
• Vehicles were well maintained and cleaned, and there were robust processes in place to monitor vehicle cleanliness.
• Staff were aware of their safeguarding responsibilities and had received the required training.
• Staffing was sufficient to meet the needs of patients.
• There was a clear induction programme and support for new staff members.
• Staff driving licence and Disclosure and Barring Service checks were performed yearly.
• Patient and relative feedback was consistently positive and stated that the service provided compassionate care.
• Staff we spoke with demonstrated a caring attitude to patients and their relatives.
• There were systems in place to monitor vehicle servicing and maintenance, vehicle cleanliness and staff training compliance.
• Staff described the culture within the service as very positive with one member of staff describing it as "the best job since leaving school". 
• Quarterly staff meetings were held and there was a communications book for regular staff messages.

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, even though a regulation had not been breached, to help the service improve.

Professor Edward Baker

Chief Inspector of Hospitals