Medicmart Ambulance Service

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

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

We have not awarded this service a score for Well-led.

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

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The values and the vision of the service was displayed for staff to see. The leaders shared their vision for the service and their strategy on how they were going to achieve it, which they had shared with staff.

Staff were happy to work for the service and were supportive of their peers and management team and felt supported by them. Staff had received training in Equality, Diversity and Inclusion and this helped and enabled them to deliver high quality care to the community. Staff did not feel that there were any cultural issues within the service and they were all treated equally and fairly.

The service had inclusive 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.

The registered manager has been in the role since 2018, since then progressing through clinical training completing their First Response in Emergency Care (FREC) level 4 training. The registered manager is also a qualified accountant and has completed other business and enterprise courses. The operations manager has 18 years’ ambulance service experience as an Emergency Medical Technician (EMT). The Operational and Training Director was trained to FREC5, they were also the safeguarding lead trained to level 4, a level 4 mentor, and were in the process of completing an Internal Quality Assurance (IQA) level 4 course. Senior Leaders undertook operational duties on the ambulance vehicles.

The service was the process of onboarding a new Medical Director, who would assist with clinical leadership and medical oversight of the service.

Staff told us that all managers were supportive and approachable, and they were confident to raise any concerns, and the service had a very open, honest and inclusive culture.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Managers told us that they had an open-door policy for staff to come in and speak to them. Staff we spoke to agreed and felt that Medicmart had a very open culture, they felt comfortable, supported and listened to when speaking up to managers without fear of repercussions. The management team took turns in holding an out or hours mobile phone so that staff could contact a manager at any time.

Staff knew how to direct patients and their families to give feedback, they would give an email address, phone number of patient feedback card. We saw in staff records positive feedback from patients.

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

The workforce was diverse and represented the community that they serviced. Staff that we spoke to of both genders felt that they were treated fairly and equitably within the organisation. Staff told us that reasonable adjustments have been made; for example, managers supporting flexible work patterns to achieve a better work life balance. As part of the recruitment process all candidates were asked to complete an equality, diversity and inclusion monitoring form which was held and treated confidentially. This enabled the service to monitor the effectiveness of their inclusive recruitment processes and make improvements where necessary.

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 reviewed regularly, clearly setting out roles and responsibilities. Collectively, these measures contributed to the effective delivery of care and treatment supporting the safety and wellbeing of both staff and the public.

The service had good data security processes. Personal staff details were kept electronically; patient transport referral details were kept both electronically and in paper form. The paper documents were kept in a locked box safe.

The service had a business continuity plan detailing processes that would be put into place should an event have an adverse effect on the service provided. For example, a fire, loss of technology and communication systems or a data breach. It also had a carbon reduction plan to aid with sustainability.

The service had a small leadership team of three people, they had regular informal meetings which were not documented; however, the quarterly meetings had a formal agenda and were documented. Topics discussed include contracts, IPC, vehicles, incidents and safeguarding.

The registered manager was able to tell us the three main risks to the service. Risks were identified and a formal log was kept on a risk register which enabled managers to keep oversight.

Staff were kept up-to-updated by managers in the form of emails and staff newsletters These detailed topics such as reminders on how to report incidents, faults on vehicles, IPC and when to be bare below the elbows, cleaning of vehicles and building security. These newsletters also reviewed policies that had changed or that staff may need refreshing on for example the social networking policy. The newsletters were a collaboration by both staff and managers with some light-hearted stories added this showed joint open sharing of information.

At the time of inspection, the service did not have regular staff meetings, but managers and staff that we spoke to all stated that there was clear and open channels of communication between management and staff.

Leaders did not have a full understanding of their regulatory responsibilities and the requirement to notify CQC of certain incidents. CQC have not received any notifications from the service in the last year .

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 service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service collaborated and worked in partnership with the commissioner organisations. The partners that we spoke to found the service engaging and did not have any concerns. Joint incident investigations would be undertaken to aid with shared learning.

The service was involved in a local university community day and a local fun day. We also saw evidence of community fund raising with money raised for a local air ambulance.

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 had a process in place to ensure that learning happened following incidents. Learning was share by email. The service had an incident reporting policy, process and system that allowed investigations to be undertaken so that learning could take place, improve care and treatment, preventing any recurrence. Staff were encouraged to continue with professional self-development. The service had also funded staff through the different levels of First Response Emergency Care (FREC) courses, which are nationally recognised prehospital care qualification.

Patient, family feedback and complaints were reviewed to see if changes and improvements needed to happen.
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.