Specialist Medical Transport - North

We rated it as inadequate because:

• The service was not safe. The service did not provide mandatory training in key skills to all staff and make sure everyone completed it. Staff did not understand how to protect patients from abuse and the service did not work with other agencies to do so. Not all staff had training on how to recognise and report abuse. Staff did not complete or update risk assessments for each patient to remove or minimise risks. The information needed to plan and deliver effective care and support was not available at the right time. Staff did not keep detailed records of patients’ care. Records were minimal but stored securely. Managers did not investigate incidents or use incidents as opportunities to learn and improve the service.
• The service did not consistently provide effective care. The service did not provide care based on national guidance and evidence-based practice. Managers did not check to make sure staff followed guidance. Staff did not protect the rights of patients subject to the Mental Health Act 1983. Staff did not support patients to make informed decisions about their care. National guidance to gain patients’ consent was not followed.
• Staff treated patients using the hospital discharge service with compassion, kindness and respected their privacy and dignity. Staff did not demonstrate the same commitment to providing compassionate care to people using the secure mental health service. The service did not evidence staff provided emotional support to patients. There was no evidence that patients were supported to understand the information they were given about their care. This included during transition or transfers.
• The service did not consider patients’ individual needs and preferences. The service did not use the complaints system to inform changes or improvements to the service.
• The service was not well-led. Leaders did not understand or manage the priorities and issues the service faced. Leaders did not operate effective governance processes, throughout the service and with partner organisations. Leaders did not identify and escalate relevant risks and issues. They did not have plans to cope with unexpected events. Managers did not collect reliable data or analyse it appropriately.

However:

• Staff kept equipment, vehicles and the premises visibly clean.
• The design, maintenance and use of facilities, vehicles and equipment kept people safe. Staff managed clinical waste well.
• The service had enough staff to run the service and meet contractual demand.
• The service was responsive because it monitored, and met, agreed response times.
• Staff treated patients using the hospital discharge service with compassion and kindness, respected their privacy and dignity.

This service has been rated as inadequate overall and so has been placed into special measures. One of the purposes of special measures is to ensure that providers found to be providing inadequate care significantly improve.