• Ambulance service

Met Medical

Overall: Good read more about inspection ratings

Unit 3a, Smallford Works, Smallford Lane, Smallford, St. Albans, AL4 0SA (020) 3627 9042

Provided and run by:
Met Medical Ltd

Important: This service was previously registered at a different address - see old profile
Important: The provider of this service changed. See new profile

Assessment report published 29 October 2025

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Well-led

Good

29 October 2025

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.
This was the first assessment of this service at this location.
This key question has been rated as good this meant the service was consistently managed and well led. Leaders and the culture they created promoted high quality and person-centred care.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Shared direction and culture

Score: 2

The evidence showed some shortfalls. The service did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities
Although the vision and values of the service were displayed staff could not tell us what they were. They could not tell us the future plans of leaders for the future direction of the service or the strategy to get there. This suggested that staff did not have the opportunity to contribute to discussions about the future of the service and any potential changes planned.
The leadership team showed their strategy and vision for 2024 and 2025 and spoke about plans to develop the service. However, they acknowledged that this was not communicated to and shared with all staff. The service also used their online website and social media to promote themselves, but services that they were either no longer undertaking or had never provided were listed. For example, the transfer of secure patients experiencing mental health difficulties and the provision of sedating them. They no longer provided “see and treat” urgent care services and this had not been provided since at least March 2025. The website and social media forums were misleading to the public. Leaders told us that website and social media pages were used as a marketing tool to aid with the development of future business. Leaders told us they would need to review and amend their website to be more in keeping with the activities and services that could be provided.
All staff had received training in Equality and Diversity and enabled them to deliver high quality care to the community. Staff did not feel that there were any cultural issues or power imbalances within Met Medical.

Capable, compassionate and inclusive leaders

Score: 3

The evidence showed a good standard. The service had leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.
Apart from the chief financial officer and owner, senior managers had clinical experience in ambulance and emergency care. Three managers were trained to level 4 safeguarding with support from an external safeguarding advisor trained to level 5. One manager also had an additional qualification in clinical management. All were registered with the Health and Care Professionals Council (HCPC). The registered manager has been with Met Medical for 11 years. There was also a medical director that supported the service remotely.
All managers understood the different aspects of the service they managed. Staff told us that while some senior managers were not consistently accessible, those that were available were described as approachable and supportive. Leaders had a full understanding of their regulatory responsibilities and the requirement to notify CQC of certain incidents.

Freedom to speak up

Score: 3

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard
The service has a Raising Concerns Policy that incorporated Freedom to Speak Up (FTSU) within it, all staff had access to this policy. The policy detailed the name and contact details of the FTSU guardian who was contracted to act on behalf of the service. The guardian is registered with the National Guardian’s Office. All staff have received training around FTSU.
The registered manager also had Speak Up, Listen Up and Follow Up training for managers and senior managers. Managers told us that they had an open-door policy for staff to come and talk to them. However, staff said that not all senior managers were accessible and available to them but those that were regarded as being approachable and supportive.
Staff knew how to direct patients and their families to give feedback, there were also scannable QR codes on the emergency vehicles for staff to scan and feedback on.

Workforce equality, diversity and inclusion

Score: 3

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.
There was diversity in the workforce of the service, including 55% women and 30% people from ethnic minority groups. As part of the recruitment process all successful candidates were invited to complete a non-mandatory equal opportunity form so that the service could monitor the workforce to keep it as inclusive and diverse as possible when recruiting new staff to be representative of the population.
Both male and female staff told us that they felt that they were treated equitably. One staff member said that they had some additional needs and felt that the service made reasonable adjustments and allowances for their requirements and this is one of the reasons why they work there. Feedback from staff has recently seen the service introduce a menopause policy proving equality and equity for people who work for them.

Governance, management and sustainability

Score: 3

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.
Leaders and staff were aware of their own roles and responsibilities within the service. Staff knew the scope of clinical practice that they worked within dependent upon role. The service policies were detailed and mostly reviewed regularly, all clearly setting out responsibilities and roles. One policy was found to be out of date in March 2025. Staff acknowledged reading the policies on their electronic devices. All staff were compliant with their training. Collectively, these factors supported the effective delivery of safe care and treatment, helping to both safeguard both staff and the public together
The service had good data security processes. Personal staff details and patient care records were kept electronically; any paper documents would be scanned before being shredded and disposed of.
The service had a business continuity plan detailing processes that would be put into place should something have an adverse effect on the service provided. For example, serious weather conditions, loss of technology and communication systems.
Managers had regular monthly governance meetings. Topics of discussion included risk register review, safeguarding, a review of any incidents and developing trends, complaints, performance KPI, training, policy and procedure reviews, clinical governance, finances, notifications to Care Quality Commission (CQC), patient feedback and any opportunities to improve the service.
The risk register was regularly reviewed and updated; managers were able to list the top three risks. The risk level was monitored using colour coded system of red, amber and green and a number scoring matrix.
Staff were kept up-to-updated by managers in the form of emails, staff newsletters and bulletins. These detailed topics such as learning from incidents, learning from safeguarding, IPC, staffing, performance updates, patient feedback and updates, training and safety matters from their contracted NHS ambulance service trust. At the time of the inspection regular staff meetings did not take place. However, following our assessment managers have implemented a daily “huddle” meeting to give the staff operational updates.

Partnerships and communities

Score: 3

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people.
The service collaborated and worked in partnership with the organisations that commissioned their services.
We also saw evidence of community collaboration and with involvement in a “restart heart week” and a career fair at a local university.

Learning, improvement and innovation

Score: 3

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice.
The service has a process in place to ensure that learning happened following incidents. The service had a strong incident reporting process that allowed for investigations to be undertaken so that learning could take place, improve care and treatment, preventing any recurrence. Examples of good practice were also shared. We saw evidence of this learning with examples of good safeguarding referrals on news bulletins. Staff were encouraged to continue with professional self-development.
Patient and family feedback and complaints were looked at and reviewed to see if changes and improvements needed to be put into place.
The service was looking to expand as a business and tender for new contracts, the business strategy had three areas patient transport services, urgent and emergency care and events. Events are not currently regulated by the CQC.