The Care Quality Commission
  • Ambulance service

Archived: St John Ambulance West Midlands Region

Overall: Good read more about inspection ratings

100 Lionel Street, Birmingham, West Midlands, B3 1DG (0121) 237 3884

Provided and run by:
St. John Ambulance

All Inspections

21 - 22 November 2019

During a routine inspection

St John Ambulance, West Midlands Region is operated by St John Ambulance. This inspection and report covered the West Midlands region only. The main service provided by this ambulance service is emergency and urgent care. The service also provides a patient transport service for the local NHS trust. Where our findings on emergency and urgent care, for example, management arrangements, also apply to other services, we do not repeat the information but cross-refer to the emergency and urgent care section.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 21 and 22 November 2019.

During our inspection we rated the service using our five key lines of enquiry. We looked at if the service was safe, effective, caring, responsive and well led. We were unable to rate caring for the emergency and urgent care service as we did not see any regulated activities being carried out.

The St John Ambulance service has both paid staff and volunteers working within the service. Throughout the report when staff are referred to it means both staff and volunteers.

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.

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.

We rated it as Good overall.

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.

  • Staff provided good care and treatment, gave patients enough to drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.

  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.
  • Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central), on behalf of the Chief Inspector of Hospitals

22 November 2016

During a routine inspection

St John Ambulance West Midlands Region is part of St John Ambulance, a national first aid charity. St John Ambulance provides a number of services including first aid at events, emergency and non-emergency patient transport services and first aid training. The objective of the organisation nationally is the relief of sickness and the protection and preservation of public health. Both volunteers and employed staff are involved with the services provided by St John Ambulance.

We inspected St John Ambulance West Midlands Region on 22 and 30 November 2016. This was an announced comprehensive inspection of the region’s patient transport services. We visited the regional operations centre and the regional headquarters during the inspection. We have reported on patient transport service, although the organisation does undertake urgent and emergency care, we were not able to see this during the inspection.

We do not currently have a legal duty to rate independent ambulance services but we highlight good practice and issues that service providers need to improve.

We found the following areas of good practice:

  • We saw a positive incident reporting culture. The national incident management framework had been implemented across the region. Staff knew how to report an incident and felt able to do escalate any concerns to management as required.

  • The planning of patient transport services (PTS) was made in advance in order that sufficient resource could be allocated to each job, taking account of individual patient’s needs.

  • Following our previous inspection in which we raised concerns surrounding the infection prevention and control techniques the service has since upgraded theirsluice facilities.Additionalcleaning and decontamination of its vehicles was provided through a third party provider.Vehicles inspected were visibly clean and we saw vehicle fully completed decontamination audit results.

  • Patients that we spoke to said that staff provided a compassionate, kind and considerate service.

  • There was a national vision and strategy that had been embedded across the region. Staff that we spoke to were aware of the strategy and understood the values of the organisation.

  • An external fleet management company maintained vehicles used by the service. Maintenance and servicing of vehicles was seen to be effective, timely and accurately documented.

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

  • Safeguarding training was not in line with national safeguarding children standards. Staff were not trained to the required safeguarding level as set out in the Safeguarding Children and Young Peoples: Roles and Competencies for Health Care Staff Intercollegiate Document: March 2014. Following the inspection the provider has undertaken work to provide the correct levels of training to appropriate staff.

Information on our key findings and action we have asked the provider to take are listed at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

26 February and 3 March 2014

During a routine inspection

We visited the regional head office located in Birmingham City Centre, Smethwick offices (Summit Crescent) and ambulance station and the Coventry offices and ambulance station. During our inspection we spoke with six emergency transport attendants (ETA), a team leader, the regional director, the registered manager, the regional assurance manager and an additional five staff members in lead roles within the organisation. We also spoke with three people who had used the service and four representatives from four services that had contracted with the St John Ambulance. The registered manager retired at the end of February 2014.

Overall the representatives we contacted were satisfied with the service provided. One of the representatives told us, 'I have been a commissioner for many years and I cannot praise St John Ambulance highly enough'. Another representative told us,'The patients tell me that they feel safe and unrushed during transfer to and from the ambulance, completely comfortable and secure during transit'.

We found that systems were in place to ensure that vehicles and equipment used were well maintained. Systems were in place to regularly clean vehicles. However, the provider needed to ensure that these were adequate to prevent risks to people that used the service.

Arrangements in place to recruit staff ensured that only staff that were suitable were employed.

Systems were in place to monitor the quality of the service and make any improvements needed.

19 February 2013

During a routine inspection

During our visit we were not able to speak with people who used the service. However, we contacted and spoke with representatives from four services that contract with St John Ambulance West Midlands. This included an NHS ambulance service, an NHS Hospital Trust and two organisers of public events. We also visited two offices and an ambulance station in Birmingham where we spoke with a group of eight ambulance crew staff and four senior staff.

The representatives we spoke with were satisfied with the service provided by St John Ambulance. They told us that they were happy to continue to use the service or use the service again for further events. Comments received from the representatives included:

'The level of service received is excellent. We have a very mature relationship with St John Ambulance.'

'Brilliant, really good. They came up with the goods and provided more staff than needed. Would definitely consider using them again.'

We found that staff received appropriate training to ensure they had the skills suitable to meet the needs of people using the service.

Processes were in place to monitor the quality of service provision. This included routine checks to ensure ambulances were roadworthy and protect people from the risk of infection. People received care and treatment in a hygienic environment.