Medicmart Ambulance Service

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.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

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 clear policies and process of reporting incidents. Incidents were reported using an electronic incident reporting system that staff could access using their personal digital devices, they could also complete a paper form. All staff and managers were aware of their responsibilities for reporting and investigating incidents. Incidents were reviewed by the operations manager and discussed at governance meetings with learning themes shared with staff in emails and staff newsletters. There were 10 incidents reported between January 2025 – January 2026 reported across the whole of the service. Staff and managers were aware of duty of candour and the need to be open, transparent and give explanations to patients and their families when things went wrong. Duty of candour was seen to be raised when there was an incident involving a patient falling from their wheelchair, the patient was treated and cared for at the time by the staff involved. The incident was investigated, learning was shared to staff, and a duty of candour letter and apology was sent to the patient.

As a registered provider of regulated activities, the service should notify the Care Quality Commission about certain changes, events or incidents that affect their service or the people using it. The service were not doing this and were therefore in breach of one of their registered registration regulations for the notification of other incidents.

Following the assessment the provider was told of this noncompliance and has since commenced submitting statutory notifications to CQC in accordance with their registration obligations.

The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service had a regular patient transport contract with an NHS hospital and contracts with two local authorities on an ad hoc basis. This work was received by email, usually the day before, containing information about the person requiring transport. The information included any medical concerns or mobility issues. The journeys were planned, ensuring that the appropriate staff and vehicle were assigned to meet people’s needs. The service also had a regular term time school contract. The same staff, where possible, were used for this child so that the child and their family became familiar and comfortable with the staff. Staff knew the patient well which aided them in recognising changes in behaviours that might indicate that the child was becoming unwell.

Contract partners informed us that they did not have any concerns regarding the transport services provided by Medicmart.

The service also received private referrals for patient transport services directly from the public by telephone. They had a telephone pro forma document, in addition to this they would use an IT system to gather all the information they needed regarding the patient. Information gathered included medical details, mobility concerns, and whether the patient was being escorted by a family member or carer. This would allow the service to plan the journey with most appropriately trained staff and vehicle. Once staff were with the patient they would also assess the patient face to face and undertake a dynamic risk assessment to ensure that they were able to complete the transport of the patient safely.

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 policy for adults and children. All policies were in paper form on site. Staff we spoke to told us that they did not know where to find them but would ask the manager for help and guidance if they needed to read or review any policies. Managers told us there were plans to upload the policies onto digital systems so that staff could gain access to them from their personal digital devices.

The service had a safeguarding lead trained to level 4 in safeguarding adults and children. The safeguarding lead had a portfolio of continuing professional development that enhanced their skills and knowledge to improve response to safeguarding concerns and support to staff.

All staff were 100% compliant in safeguarding adults’ level 2 training and 63% of staff were compliant with safeguarding children level 2, this was reflected practice in line with the Royal College of Nursing intercollegiate document on safeguarding. Some staff had not completed their training because that had recently been employed and they were given 6 months to complete all mandatary training . New staff would work with senior or more experiences staff until they had completed their competencies. We saw training was on the risk register of the service so that managers could monitor completion.

Staff told us how to identify adults and children at risk of abuse or harm. Staff gave examples that demonstrated what actions they would take to protect patients; they 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 governance meetings.

The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We did not have the opportunity to observe staff undertaking their normal work duties; however, staff told us they spoke to and listened to the people they cared for to get the information they needed, to enable them to manage risk and ensure that their needs and requirements were met. Staff completed manual handling training to help reduce risk when moving patients that were immobile or had mobility issues. They worked within their own clinical competencies’ and would request additional help and assistance if a patient became unwell during a journey.

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 delivery of safe care.

We inspected 1 out of 2 vehicles used for patient transport services. The vehicle was visually clean inside and out. We found the Automated external defibrillator (AED) loose and a rip in a passenger seat which was covered with tape this was reported to the registered manager the AED was secured and the seat noted to be repaired. The vehicle was used regularly for the transport of a child with complex needs and had toys on board.

Staff undertook daily vehicle inspections at the beginning of their shift; these were recorded electronically on their personal devices. All equipment was visually clean, serviced and had been portable appliance tested (PAT).
The service has a part-time Make Ready Officer (MRO) who restocked and monitored equipment levels on the vehicles, identifying any shortages and escalating any concerns to managers if necessary. Staff had access to equipment and consumables should replacements be required at times when the MRO was not available. Faulty equipment was taken from the vehicles, documented and put into a separate storage unit; this avoided any confusion of equipment getting mixed up.

The service had appropriate safety harnessing for the transportation of children.

Fire alarm checks and fire risk assessments were completed and documented. Fire extinguishers were calibrated and in date. All vehicle and store cupboard keys were locked and secured.

The service had a Control of Substances Hazardous to Health (COSHH) substance folder with appropriate signage giving staff information on how to use and store the substances safely. Clinical waste was disposed of safely.
The non-clinical environment appeared generally well maintained and clean. Staff had a social area and a small kitchen area with facilities to prepare hot and cold food and drinks. The grounds of the property and all three industrial units within it were protected by CCTV and a security gate.

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 met people’s individual needs.

The service had a safe recruitment process; the service used an external company to assist and to give help and advice around any Human Resources (HR) issues. All staff employed by the service, either on a permanent or temporary basis, were subject to an enhanced Disclosure and Barring Service check (DBS). New staff received an induction and orientation into the service and a staff handbook.

All staff were qualified within their own clinical competencies to undertake their role, and they were aware of their scope of practice within their clinical skill group. Staff could access their clinical scope of practice from a staff portal available to them from their electronic devices.

The staff were qualified and had the right skills and knowledge to treat and care for the patients that they were presented with. Staff said that if they were presented with a patient requiring treatment outside of their clinical competency, they would request additional assistance to scene.

Staff were offered additional training programmes that were supported and funded by the provider. Four members of staff have been supported to complete their First Response in Emergency Care (FREC) courses to levels FREC 4.
The operational and training director was also a level 4 mentor and in the process of completing an Internal Quality Assurance (IQA) level 4 course. The service had a training policy in place.

Not all PTS staff had completed their mandatory training or received an appraisal. Some staff had recently been employed by the service and PTS staff had six months to complete their training and were not due for appraisal. Training and appraisals was on the service’s corporate risk register for monitoring for completion by managers.

The service had access to a training system that triggered an email to staff 2 months before any mandatory training was due to expire with a reminder sent one month before and then a week before. Training was a mixture of online and face to face training. Staff receive some end-of-life care training at induction and training around Do not attempt cardiopulmonary resuscitation forms (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment forms (ReSPECT).

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

One PTS vehicle that we inspected had a rip in the passenger seat that had been covered with tape this was pointed out to the registered manager who told us they would note this and take steps to get it rectified.

Cleaning materials were available to be used with signage indicating what chemicals should be used for specific areas. There were chemical dispensing units fixed to walls to ensure that correct amount of chemicals were used. There was a colour coded signage system in place for mops and buckets with the service using disposable mop heads to avoid cross contamination within the cleaning areas.

The service used an external company to deep clean their vehicles, which were deep cleaned every 6 – 8 weeks. Swab testing was conducted before and after deep cleaning with high preclean swab tests found on the windowsills, trolley beds and worksurfaces in June 2025. High vehicle swab rates were added to the services risk register for infection protection control to be monitored by the management team to increase checks on vehicle cleaning. Deep clean audits have shown that swab testing preclean rates had vastly improved in all of the following months to date, demonstrating that the monitoring of cleaning by management was working.

The service had an infection protection and control (IPC) policy. Staff understood their responsibilities around IPC; staff hand hygiene audits are carried out by the service. Personal protective equipment (PPE) was worn where appropriate. Staff carried out vehicle cleaning at the beginning and end of their shift, as well as in between patient transfers throughout the day. If a person was transported with a known infectious disease staff would return the vehicle and equipment back to their base station for appropriate and thorough cleaning.

The vehicles and reusable equipment were visually clean and tidy, personal protective equipment (PPE) was available to staff. Decontamination wipes and clean linen were available.

All non-clinical areas were observed to be clean and tidy maintained by staff as part of their daily operational roles. IPC was discussed at governance meetings.

The service did not always make sure that medicines were safe.

Staff had access to systems and processes to administer medicines safely. Medicine policies and procedures had been reviewed in April 2025.

The service had a medical gas policy which also provided guidance to support staff on patient transport vehicles (PTS) who may administer medical gases. Medical gases were stored safely and securely with clear segregation between full and empty cylinders. However, there were no warning signs visible to warn people about smoking and naked flames near a medical gas store. We were assured that this would be rectified immediately. Since our onsite visit we have received evidence that warning signs are now displayed.
We were shown how medicine incidents would be recorded although there had been no medicine incidents reported.