The Care Quality Commission
  • Ambulance service

Archived: Cartello Ambulance

Overall: Requires improvement read more about inspection ratings

Unit 6 West Cannock Way, Chase Enterprise Centre, Hednesford, Staffordshire, WS12 0QW (01543) 897200

Provided and run by:
Cartello Adams Ltd

Important: This service is now registered at a different address - see new profile

All Inspections

31 March 2021 and 7 April 2021

During an inspection looking at part of the service

Cartello ambulance is operated by Cartello Adams. The service was first registered with CQC in September 2014. It is an independent ambulance service in Hednesford, Staffordshire. The service primarily serves the communities of the West Midlands. The current registered manager has been in post since 2017. The service is registered for the regulated activities of patient transport services.

The service is registered to provide the following regulated activities:

  • Patient transport service

During the inspection, we visited Hednesford (Staffordshire) location. The service provides regular

services, such as taking and picking up children with complex medical needs from school or day centres; however, since the pandemic of COVID 19, school run services have currently ceased until further notice.

Cartello ambulance main service is to supply ambulance vehicles to other private ambulance providers on a sub-contractor basis, transporting NHS patients discharged from hospital or attending outpatient appointments. The service was also contacted on an ad-hoc basis if other patient transport services were not able to meet patient demand. During the inspection, we visited the Hednesford location, where the office and garage, which housed the vehicles, were situated.

Cartello ambulance was last inspected on 15 and 22 October 2019. Following the inspection, the service was issued with two requirement notices which related to Regulation 13 HSCA (RA): Safeguarding service users from abuse and improper treatment and Regulation 17 HSCA (RA): Good governance. The service was also given five areas where they must improve, and additionally six areas where the service should improve. The provider shared their action plans with CQC.

In the reporting period of November 2020 and February 2021, CQC received information of concern about Cartello ambulance. A decision was made to carry out a focussed inspection of the safe and well led domains to investigate the concerns.

15 and 22 of October 2019

During a routine inspection

​ Cartello Adams is operated by Cartello Adams Ltd . The provider provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the un announced part of the inspection on 15 October 2019 , along with an announced visit on 22 October 2019.

To get to the heart of patients’ experiences of care and treatment , we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Me ntal Capacity Act 2005 .

The main s ervice provided by this service was a patient transport service .

This was the first time we rated the service . We rated it as Requires improvement overall.

  • N ot all staff were trained to the correct level of safeguarding and there was no safeguarding lead.

  • Staff did not always complete risk assessments for patient s to minimise risks.

  • Not all staff had completed their infection control and prevention training.

  • Staff records of patients’ care and treatment were variable. Records were not always clear or up-to-date .

  • Not all incidents were disseminated down to front line staff.

  • We did not see evidence that the provider was using data to make improvements.

  • There were no local clinical audits completed.

  • Managers did not always appraise staff’s work performance, only 50% of staff had received appraisals.

  • There was no formal recorded vision and strategy for the service.

  • Risks and issues and identified actions to reduce their impact were not always documented.

  • Leaders sometimes understood and managed the priorities and issues the service faced. There was inconsistent feedback about how visible and approachable leaders were in the service for patients and staff.  

However:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.

  • The service-controlled infection risk. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment, vehicles and premises visibly clean . The design, maintenance and use of facilities, premises, vehicles and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.

  • Staff identified and quickly acted upon patients at risk of deterioration. The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. The service used systems and processes to safely administer, record and store oxygen. The service provided support based on national guidance and evidence-based practice. Staff protected the rights of patients in their care.

  • Staff assessed patients’ drink requirements to meet their needs during a journey. The service monitored, and agreed response times so that they could facilitate good outcomes for patients. All those responsible for delivering care worked together as a team to benefit patients. They supported each other to provide good care and communicated effectively with other providers of healthcare .

  • Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. They knew how to support patients who lacked capacity to make their own decisions. Staff treated patients with compassion and kindness, respected their privacy and took account of their individual needs. Staff provided emotional support to patients, families and carers to minimise their distress. Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.

  • The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care. The service was inclusive and took account of patients’ individual needs and preferences. The service made reasonable adjustments to help patients access services.

  • People could access the service when they needed it and were able to provide the service at short notice. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service had an open culture where patients, their families and staff could raise concerns without fear.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with requirement notice(s) , Details are at the end of the report .

Heidi Smoult

Deputy Chief Inspector of Hospitals

17 January 2017

During a routine inspection

Cartello Ambulance is operated by Cartello Adams Limited and provides a patient transport service. The service was registered on 4 September 2014 and provides a service for both adults and children.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 17 January 2017.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

Cartello provided regular services such as taking and picking up children with complex medical needs from school or day centres, supplying ambulances to another private ambulance on a sub-contractor basis and transporting NHS patients discharged from hospital or attending outpatient appointments. The service was based in Hednesford, Staffordshire. There was an office and a garage, which housed the seven ambulance vehicles

We found the following areas of good practice:

  • The service employed staff who were knowledgeable about how to carry out their role.

  • We saw that vehicles and equipment were clean and well maintained.

  • Staff worked effectively with other providers in order to provide the transport service.

  • Staff were caring, helpful and respectful.

  • Staff within the service had completed training to assist with meeting the needs of individuals including patients living with dementia and learning disabilities.

  • There was a positive culture within the organisation with approachable leaders.

However, we also found the following issues that the service provider needs to improve:

  • A culture of incident reporting was not embedded in the service. Staff reported incidents verbally but there was no formal recording of incidents or their severity or how learning from incidents had been shared.

  • We saw that patient records were not always available or complete and did not specify patients’ needs or actions to be undertaken in an emergency.

  • Staff and managers were not aware of the duty of candour regulations or actions that the service was required to undertake under these regulations.

  • There were no practical checks of driver competence at the time of our inspection although this was planned.

  • Staff had never had an appraisal or a formal review of their performance.

  • The safeguarding policy included both safeguarding vulnerable adults and children but did not fully detail the legislation to safeguard both vulnerable groups.

  • The organisation did not have any policies or procedures that referred to obtaining consent from patients or considerations, which should be made with regard to the Mental Capacity Act 2005.

  • There was no formal recorded vision and strategy for the service.

  • Governance arrangements needed to be strengthened to ensure the service was able to develop systems to minimise the risk to patients and staff.

  • There was no registered manager or responsible individual for the organisation.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices, details of which are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals