Head Office

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence people and communities had the best possible outcomes because their needs were assessed. We checked people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service provided effective care.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The evidence showed some shortfalls. The service did not always make sure people’s care was effective because they could not demonstrate that appropriate observations were always carried out.

We reviewed 3 patient records during our assessment. The transport booking form included a risk assessment that was completed by the referrer and reviewed by the transport coordinator on receipt.

The provider had processes to assess needs but could not consistently demonstrate effective monitoring during higher-risk transfers, particularly where sedation or restraint had been used. We reviewed a patient transfer record where they had been given sedation prior to pick up and a registered mental health nurse had been tasked with leading the transfer. We saw that detailed notes were recorded on the patient transfer record. We were told that clinical observations were completed due to the sedation received, however, these were not recorded in this case. We reviewed the restraint policy and found the policy did not outline the level or type of observations but did stipulate where restraint was used, this should be recorded on the transport record. Following our assessment feedback, service leads updated their restraint policy. However, at the time of assessment the policy did not provide clear guidance regarding observations following sedation or restraint. The patient transfer record included a record of the patient’s medical history, identified risks, the use of restraint, if sedation had been used prior to patient pick up and if the patient had been offered or accepted food or drink.

Staff described the assessment process and how this was an ongoing dynamic process during the patient transfer journey. This included ongoing assessment of risk and patient needs.

In the records we reviewed we found all included details of the assessment of the patient’s general wellbeing, where pastoral care and support was provided to reassure the patient.

The evidence showed a good standard. The service planned and delivered people’s care with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff assessed and met patients’ needs for food and drink. We saw that food and drink had been offered in all patient journeys except where the journey had been a short transfer.

Staff were experienced, qualified and had the right skills and knowledge to meet the needs of the patient group. All had received training in restraint, de-escalation and the risk assessment process. Training was both online and classroom based, giving staff the opportunity to discuss and develop their skills such as appropriate use of restraint and de-escalation.

Managers provided new staff with an induction that included shadowing experienced crew members and completing competency-based training and assessments before working independently.

Managers provided staff with supervision to reflect and learn from practice. This included meetings to review incidents and use these as scenario training to identify good practice and develop individual skills in appropriately responding to patient needs and situations. Staff told us they had regular opportunities to debrief with managers following a patient transfer.

Staff received regular appraisal of their work performance. Staff told us the appraisal process was useful and effective. Records we reviewed showed that 80% of current staff had received an appraisal in the last year, with arrangements in place for the completion of the other staff appraisals. Where staff were new into post they had a probationary review within the first few months.

Team meetings were arranged and these were attended by office staff. Crews were invited to attend meetings but did not always attend due to the nature of their part time and ad hoc roles. Managers communicated key information to crews with email updates and verbal discussions when they attended the office. In addition, in-house training was provided regularly and there were opportunities in classroom-based training and supervision sessions for information updates to be shared.

Managers addressed staff performance concerns through additional training and support. They also gave examples where employment was not confirmed after induction when performance concerns had not been resolved.

The evidence showed a good standard. The service worked well across teams and services to support people.

Staff worked well as a team to meet patients’ secure transport needs. Staff told us crews worked well together to support patients and provide safe transport. We were given examples of how staff worked well across healthcare disciplines and with other agencies when required to care for patients.

Staff gave us examples of when they worked with referring and receiving organisations to ensure good outcomes for patients including requesting and handing over risk information relevant to the transfer of the patient.

We reviewed records where managers had engaged with other services and professionals, including local authority safeguarding teams, as part of investigations to ensure patient safety and safeguarding.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control.

Head Office at SSC Secure Patient Transport Ltd is a service offering secure patient transport services for patients who require safe, secure transport, for example, to appointments. This quality statement is not relevant for this service as people were seen for one off patient transport journeys, and their use of the service did not include supporting people to live healthier lives.

The evidence showed a shortfall in standard. The service routinely monitored people’s transport and care. However, it was not clear how the data was used to continuously improve. Therefore there was limited assurance that outcomes met both service expectations and the expectations of people themselves.

Patient transfers were audited to check the effectiveness of the care and transport provided. The audit checked the timeliness of transport, the reason for cancellations, the use of restraint, handcuffs, and the secure patient area within the transport vehicles.

The service aimed to meet transport requests within 2 hours if appropriate. Data showed 66% of transport journeys were on time and 34% were delayed. We were told there were various reasons for delayed transport journeys, which included the patient not being ready, finding appropriate crew members to do the job and other reasons beyond the provider’s control. However, the reasons for the delayed pick-ups were not clear, and data around this was not available, therefore, it was unclear if the service was doing everything possible to monitor and improve performance in this area.

Data showed that on average between January and June 2026 physical restraint was carried out on 2.68% of patient journeys. We saw that the secure transport area within the vehicles was used on 15.5% of journeys between October 2025 and March 2026 and that handcuffs were used on 5.5% of journeys for the same period. However, the data did not include analysis of the appropriateness and correct use of restraint and how monitoring was used to learn and improve.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment. However, consent was not consistently recorded in the patient record.

Staff took all practical steps to enable patients to make their own decisions if appropriate. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately in a mental capacity section on the patient transport record. However, there were inconsistencies in how consent was recorded when patients did have mental capacity. Of the 3 records we reviewed, 2 did not have consent recorded and the third had consent recorded narratively in the journey report section. There was no specific section to record where patients had consented. However, we raised this with service managers on the day of our visit, and they updated the form to include a consent section.

Staff understood how and when to assess whether a patient could make decisions about their care. Staff we spoke with described how they gained consent from patients for their care in line with legislation and guidance.

Staff received and kept up to date with training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We saw that 100% of staff had completed this training.

Staff understood relevant consent and decision-making requirements under the Mental Health Act, MCA 2005 and Children Acts 1989 and 2004. They knew when to seek managerial advice. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings and current situation. This included deciding not to transport the patient at times.