Met Medical

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.
This is the first rating of this service at this location.
This key question has been rated as good this meant that people’s needs were met through good organisation and delivery.

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 a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Staff behaviour clearly reflected a commitment to prioritising the needs of the people they were treating. They gave people information that supported them in their choices around their own treatment and care which reflected their physical, mental, emotional and social needs.
For those without capacity, previously documented information, as well as discussion with family and carers were all taken into consideration to make a best interest decision. The person involved was at the centre of the discussions and care plans that were put into place.
Shared decision making was observed with other healthcare professionals. Referrals were made for follow up appointments where needed. This acted as a safety net by ensuring people received timely guidance and access to suitable services reducing the risk of unmet needs or avoidable emergency attendances. People were given advice around changes in their condition, and this was documented concisely and was understood by the people involved, their families and carers.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.
The service has access to various care pathways, including A&E, GP services and more specialised areas including stroke units, cardiac care centres and trauma centres. The care that patients needed was coordinated and responsive to meet their needs, to achieve the best possible outcome for patients and their families. Continuity of care was observed between the staff and other healthcare professionals within the hospital and community environments.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual need.
The service had an accessible information policy that all staff had access to. Staff were aware that people have different ways of communication and needed to be supported with that. The service had a communication aid that included pictures and diagrams. Staff also had access to a language line for translation and interpretation for patients whose first language was not English. Staff had also used other forms of communicating with patients for example writing information down for people who were hearing impaired. All information was given in a way that was suitable for the person involved and/ their families or carers when lack of capacity was a concern. All staff had completed training in dementia, autism and learning disabilities and were aware of communication difficulties that these additional needs may bring.
All staff had completed training with General Data Protection Regulation (GDPR). Staff knew of the importance of keeping patient information confidential, with appropriate information sharing when it was needed. Patient care records were kept confidential and stored electronically. Any paper documents were scanned before being shredded and disposed of appropriately.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.
The service had a complaints policy and process which detailed the timeline for the investigations into complaints, the three stages of the complaint process and escalation to the Independent Sector Complaints Adjudication Service (ISCAS) if needed. However, this version of the policy was four months overdue for review at the time of our assessment.
The service had 3 complaints in the 9 months prior to our assessment, 1 relating to urgent and emergency care at an event that had been upheld. Complaints had been thoroughly investigated, with reflection and learning taking place. The outcomes of the investigations were also shared with the complainant ensuring a duty of candour.
The contracted NHS ambulance trust monitored the services complaint process and had not identified any concerns.
Staff knew how to inform patients how to complain or give feedback about their experience of care by phone call, email or by using the QR code that was on view in all the vehicles.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.
This service provided contracted 999 support to an NHS emergency ambulance trust; therefore, the service received their calls to treat and care for people via the NHS trust call centre. This enabled people to have equal access to the care, treatment and support that this service provided when they needed it. The contracted NHS ambulance trust monitor Ambulance Quality Indicators (AQI) and other Key Performance Indicators such as response times and patient outcomes to treatment and care. The ambulance trust told us that there were no concerns regarding the service’s performance.
Staff had access to tools and guidance to aid them with care assessment to enable them to signpost and refer people to the right care pathway.
They also had access to equipment to support people with mobility problems.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailor their care, support and treatment to respond to this. The service had an Equality, Inclusion and Human Rights Policy that all staff had access to. Staff have also had Equality and Diversity training. We observed staff demonstrate tailored care and support to all the people that they encountered. They listened to and acted on the information they were given. One person they treated did not have the capacity to make decisions for themselves, making them vulnerable and likely to experience inequality with treatment and outcomes. Staff used documented information and family to support and make the best of interest decision on behalf of the patient, improving their experience and outcome.

The evidence showed an exceptional standard. All staff have received training in end-of-life care, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) documentation. When spoken to, staff demonstrated a sound understanding of the key considerations associated with these areas. The staff we observed did not have the opportunity or need to engage in future care planning discussions with patients they treated. However, they were able to implement existing plans that had already been established for a patient experiencing deteriorating health. The patient did not have capacity, but care records informed the staff of the care and wishes of the patient. Documentation was in place and based on this, together with sensitive and respectful conversation with family, a care plan was put into place to support the patient as they approached a time when their life was coming to an end.