Met Medical

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment of this service at this location.
This key question has been rated as good, this meant that people were safe and protected from avoidable harm.

This service scored 66 (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 had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.
The service had a clear policy and process of reporting incidents. Incidents were reported using an electronic incident reporting system that staff could access via their personal devices. All staff and managers were aware of their responsibilities for reporting and investigating incidents. Incidents were reviewed and discussed at governance meetings with learning and themes cascaded to staff in monthly staff newsletters and bulletins. There were 166 incidents reported between July 2024- June 2025.
There was a duty of candour policy. Staff and managers were aware of the need to be open, transparent and give explanations to patients and their families when things went wrong.

The evidence showed some shortfalls. The service did not always work well with people and healthcare partners to establish and maintain safe systems of care.
The service received private referrals for patient transport services, directly from the public via the telephone. These were recorded for quality assurance and audit purposes. The service had a telephone triage policy where there is a predefined call script for structured call handling. We were not assured that staff had received any formal telephone triage training or that a predefined script was being used. There was also a patient eligibility policy, the criteria looked at the patients’ medical and mobility needs, which would influence the type of transport required and any medical support that might be needed. Patient information taken should be documented on a “patient transfer document”. We did not see evidence on site that any of these documents were being used and therefore could not be assured that a safe system was in place around private referrals and transport. The service has contracts with a local Integrated Care Board (ICB) This work was received via email, usually the day before, containing information about the person requiring transport. The journey was planned, ensuring that the appropriate staff and vehicle were assigned to meet the needs of the person involved. The contracted partners monitored these journeys for late or missed appointments that may have an impact on the health needs of the person involved. Contract partners informed us that they had no safety concerns regarding the transport services provided by Met Medical.
Staff told us that if a call came in that indicated an emergency, they would direct the person to put the phone down and call 999.

The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. The service had safeguarding policies for adults, children and young people which staff had access via their electronic devices. They had a safeguarding lead trained to level 4 in safeguarding adults and children with two other managers trained to the same level. The service also had an external safeguarding advisor trained to level 5. All staff received training specifically for their role on how to recognise and report abuse. All staff were trained to level 3 safeguarding. This is reflected good practice in line with the Royal College of Nursing intercollegiate document on safeguarding. There was 100% staff compliance in safeguarding training for both adults and children. The safeguarding lead had a portfolio of continuous personal development which enhances skills and knowledge to improve response to safeguarding concerns and support to staff. The staff we spoke with knew how to identify adults and children at risk of abuse or harm examples could be given of how to protect patients from this. Staff knew their responsibilities for the notification of safeguarding incidents and the referral process. Healthcare partners told us that they monitored the services safeguarding referrals and had not identified any concerns. Safeguarding was discussed at monthly governance meetings and there was a focus on learning from safeguarding incidents on staff bulletins and updates.

The evidence showed a good standard. The service worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe and supportive.
Staff told us they spoke to and listened to the people they were caring for to get the information they needed about them to manage any risk and ensure that their needs and requirements were met. Staff completed manual handling training that was regularly updated to help reduce risk when moving patients that were immobile or had mobility issues. They work within their own clinical competencies’ and would request help if a patient became unwell during a journey.

The evidence showed some shortfalls. The service did not always detect and control potential risks in the care environment. They did not always make sure equipment facilities and technology supported the safe delivery of care.
Our observations showed that there were not always effective arrangements to monitor the upkeep of the equipment and vehicles. On the first day of the assessment, we inspected 2 vehicles used for patient transport services. The vehicles were more dated than those used for urgent and emergency work, with some rust on the external steps. The vehicles were found to be visibly dirty. Prior to our assessment concerns had been raised that vehicles were not being cleaned at the start and ends of shifts. Our observations during the inspections suggested that these concerns were substantiated.
On one vehicle the wheelchair was not secured safely. We found a front-line emergency grab bag on one vehicle. The first aid kit, personal protective equipment, (PPE) and decontamination wipes were out of date and there was no bin available. We reported this to a manager. We reviewed these findings on our second day and found that they had been rectified with the wheelchair secure.
Equipment had been regularly serviced, portable appliance testing (PAT) was being undertaken on the second day of our site visit. However, it was unclear from stickers on equipment if they had been PAT tested. As a result, staff may have been unable to identify and replace equipment that was overdue for maintenance or renewal.
The fire extinguisher on one vehicle was out of date. Fire alarm checks are completed and documented with a fire risk assessment having been completed.
The service had appropriate safety harnessing for the transportation of children.
The service does had a fleet lead who took responsibility for vehicles including servicing and MOT.
There was a digital key safe to keep all vehicle and store cupboard keys locked and secure. The service had a Control of Substances Hazardous to Health (COSHH) policy and a COSHH substance folder with appropriate signage, but the COSHH cupboard was found to be unlocked increasing the risk of accidental exposure to hazardous and harmful substances.
The non-clinical environment appeared generally well maintained. Staff had a social area and lockers. However, there is no on-site toilet facilities. As a result, staff used a shared toilet that is not within the compound of the premises. These toilets were not visibly clean. The toilets were not owned by the service and therefore the cleaning of them was not in their remit. Soap and handwashing facilities were readily available to staff.
Some concerns were raised by inspectors around staff safety at night, staff we spoke to said that although not ideal there was lighting in the area as well as CCTV and a security guard, and they did not feel unsafe.
Confidential waste was shredded and then disposed of appropriately.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that meets people’s individual needs.
The service had a recruitment policy and safe recruitment processes. All staff employed by the service, either on a permanent or an ad-hoc basis, were subject to an enhanced Disclosure and Barring Service check (DBS). This was evidenced on site. New staff received induction and orientation into the service where they were made aware of policies and procedures, incident reporting, the incident reporting system, issued uniform and ID cards. They were also assessed within their clinical scope of practice around basic and intermediate life support and completed all mandatary training. They were subsequently supported through shifts where they worked as a third crew member, allowing them to gain experience alongside more established staff.
Staff said that if they were presented with a patient requiring treatment outside of their clinical competency, they would request additional assistance to the scene or seek clinical advice via the contracting NHS ambulance trust or a Met Medical manager.
The service had a clinical team leader who had oversight of staff training and compliance. There is also an education and training policy. All staff are 100% compliant with their mandatory training. Training compliance was audited by computer software that enabled staff to see if training is current, due or expired. The system triggered an email to staff three months before any mandatory training was due to expire. Training is a mix of online and face to face training. Staff we spoke to felt supported by the service when it came to their training. Staff have yearly appraisals, but the service acknowledged that there is still work to do in this area and not all staff had received their yearly appraisal.
We evidenced feedback from people that said that they felt confident in the care received by staff.

The evidence showed some shortfalls. The service did not always assess or manage the risk of infection. They did not always detect and control the risk. Staff had not ensured that vehicles used to transport patients were clean and well maintained. The PTS vehicles we inspected on the first day of assessment were found to be visibly dirty; personal protective equipment (PPE) was available to staff but out of date. One vehicle did not have a bin. This was brought to the attention of managers and was rectified by the next day with the vehicle being deep cleaned and the bin replaced. PPE was still out of date. Vehicles should have been cleaned at the beginning and end of shifts and in between patients. We had received concerns prior to our assessment that this was not happening. Our observations of vehicle cleanliness during our assessment supported the concerns raised.
The service uses an external company to deep clean vehicles. The service’s IPC policy states that vehicles used for PTS care should be deep cleaned every 8 weeks. However, data and audit information showed that this was not always happening within these timescales. Vehicles, on occasion were going up to 11 weeks between deep cleans.
The service had an Infection Prevention and Control (IPC) lead and an IPC policy, that all staff had access to via their electronic devices, which outlined clear responsibilities for staff and managers around IPC. Staff were 100% compliant in IPC mandatary training and were able to explain the importance of IPC when caring for people.
There was safe disposal of clinical waste and sharps, sharps bins were dated and labelled correctly. The service has a contract with a company to collect and dispose of clinical waste. Decontamination wipes and clean linen were available.
If a patient was transported with a known infectious disease a manager was contacted for guidance around appropriate cleaning. Staff were observed to be bare below the elbows.
There was signage around IPC and cleaning, staff had access to cleaning products, mops and buckets were colour coded, and disposable mop heads used.
The service completed a staff hand hygiene and uniform audit over a three-month period from beginning of April to end of June 2025. All staff audited were compliant. It is not clear how frequently these audits take place.
All non-clinical areas were visually clean and tidy with staff undertaking cleaning as part of their station duties. IPC was discussed at governance meetings.

The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involve people in planning, including when changes happen.
Staff followed systems and processes to prescribe and administer medicines safely. The provider had access to up-to-date national guidance which they followed. Staff only administered medicines within their scope of competency and within approved lists of medicines set out by their NHS contracts. There was a medicines policy in place. This included information which signposted staff to refer to contracting NHS organisations PGDs when conducting work for that organisation.
Medical gases were stored in line with best practice, and a process was in place to monitor and identify when oxygen and nitrous oxide gas cylinders required replacement.
Staff followed national practice to check patients had the correct medicines when they were transported, or they moved between services. Records included details of medicines administered by staff, including the use of medical gases. Staff received regular training in medicines management, including the use of medical gases, and had access to supporting information to promote safe practice. Staff learned from safety alerts and incidents to improve practice. Certain staff were subscribed to receive medicines safety alerts and management ensured actions were taken and recorded when relevant to the service.