Met Medical

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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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.
This is the first assessment of this service at this location.
This key question has been rated as good, this means that people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed an exceptional standard. The service always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.
We observed staff listening to patients they were treating, considering not only what they needed but what they wanted, making the whole care experience patient centred. People were provided with support and information to enable them to make an informed choice and decision around their own care and treatment. Physical and communication needs were taken into consideration. Full capacity assessments were done and where needed additional assistance from care staff and family were sought to support this. One patient did not have capacity and was living in a care home. Records on site indicated that the patient had made plans for health deterioration. A respectful discussion was held with family and lasting power of attorney for health and wellbeing. Clear care and treatment plans were put into place; shared decision making was observed with other healthcare providers and documentation was completed to a high standard. The patient involved were safety netted, with advice given should anything around their condition change, they were also advised how to seek further help if it was needed.
People that were conveyed into hospital were reviewed and reassessed as needed throughout the journey, using the appropriate monitoring equipment.
People we spoke with felt confident that their needs had been assessed and had been fully understood by staff. People felt that they had received care and treatment that was appropriate to them.

The evidence showed a good standard. The service always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards. People received care, treatment and support that was evidence based and in line with good practice standards. This was confirmed through our observations during our assessment, staff used their skills and knowledge to assess the patients’ needs to determine what treatments may be required to benefit the patient.
Staff had access to other pathways of care and treatment as an alternative to A&E or if they were treating a patient who was experiencing symptoms requiring more specialised care. This was in keeping with the contracted NHS ambulance trust and national guidelines. The NHS ambulance trust told us that this service was compliant with National Ambulance Service Quality indicators (AQIs) and care bundles. AQIs look at various aspects of a service to provide a view of the quality of care and efficiency of a service from call and response times to the clinical outcomes of treatments received by patients.
The provider had systems to ensure that staff were up to date with evidence based on good practice and required standards. Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines could be accessed via staff electronic devices.

The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff had access to policies, guidelines and other assessment tools to enable them to appropriately plan, assess and deliver safe care and treatment to support people. We observed staff working well together as an ambulance crew, with other healthcare professionals and NHS colleagues. Patients were listened to, information and treatment plans were written down and documented with comprehensive patient handovers observed providing smooth transition and continuity of care as the patient was transferred between different services.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.
Staff demonstrated that they were able to give people help and support to have choice and control around their own lives and to remain independent within their own homes engaging in conversations around health and wellbeing.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.
Staff we observed used the equipment available to them to monitor patients, recognising that any changes in observations may indicate a change in a patient’s condition. This allowed them, together with patients, to make informed and considered treatment choices and monitor outcomes of treatment. Staff had access to national sepsis guidance tools and National Early Warning Score 2 (NEWS2), to allow them to quickly assess patients and identify those at risk of deteriorating. Patients told us that they felt that the staff fulfilled their expectations of treatment and care.
National Ambulance Quality Indicators and Care Quality Indicators of this service were audited by the NHS ambulance with which it is contracted. The trust reported no concerns regarding the service in relation to these areas. They are also discussed at monthly meetings with the service.

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.
Staff understood the importance of obtaining consent before delivering care and treatment, ensuring that patients fully understood what they were consenting to. The service had 100% staff training compliance with the Mental Capacity Act (MCA) and Mental Health Act (MHA). Staff demonstrated an awareness of the MCA when we spoke to them during the inspection.
Staff were observed ensuring that patients received information around care and treatment in a way that they understood. Patients were supported to make informed decisions and be fully aware of what they were consenting to. Following a capacity assessment, one patient did not have capacity. There was documented evidence of the patient’s wants and needs. There was evidence of involvement of family and lasting power of attorney for health. A best of interest decision was subsequently made, which respected the views and wishes that had been documented at a time when the patient did have capacity and was able to make decisions.
Consent was gained and documented with care and treatment plans put into place to meet the needs and expectations of all patients observed on the assessment of this service.