Alpha Care Ambulance Service

On this page

• 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

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.

At this assessment, we found the service had made improvements since the previous assessment; however, it remained in breach of Regulation 17 (good governance). Governance and oversight systems did not consistently identify, monitor or address risks. Leaders could not always demonstrate effective monitoring of staff recruitment and driver compliance, vehicle cleaning or audit activity. In several areas, records did not align with policy requirements or provide sufficient evidence that checks had been completed and acted upon, limiting leaders' ability to effectively assess, monitor and improve the quality and safety of the service.

Despite these concerns, leaders had strengthened governance arrangements since the previous assessment and had introduced regular governance meetings, improved incident oversight, enhanced staff training and developed more structured systems for monitoring performance and risk. Staff described leaders as visible, approachable and supportive, and told us they felt able to raise concerns and contribute to service improvement. Leaders demonstrated a commitment to learning, acted on issues identified during the assessment and worked collaboratively with partner organisations to support the delivery of person-centred care.

At our last assessment, we rated this key question as requires improvement.

At this assessment, the rating improved to good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, 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 service had a vision to deliver a high-quality, cost-effective and patient-centred service that treated people with dignity and respect. Leaders promoted this vision through a skilled and compassionate workforce that worked openly, honestly and collaboratively. Staff understood the importance of providing caring and respectful support and demonstrated a commitment to delivering positive experiences for patients and their families.

Leaders supported the service's vision by fostering a positive and supportive culture. They recognised and celebrated staff achievements through a “well-done board”, encouraged teamwork, listened and responded to feedback, and invested in staff development and training.

These approaches helped maintain staff competence, wellbeing and engagement, while supporting the delivery of safe, effective and person-centred care. The service's values and objectives reflected a commitment to achieving positive outcomes and experiences for patients, relatives and staff.

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.

Leaders demonstrated a range of skills, knowledge and experience to manage the service effectively. They understood the priorities and challenges facing the service and took appropriate action to manage these. Leaders were visible and approachable, and staff told us they felt supported in carrying out their roles.

Leaders took incidents seriously and responded appropriately when concerns were raised. They investigated issues and used learning to support service improvement, which helped promote a positive and open culture.

Leaders also undertook patient-facing duties, enabling them to maintain oversight of service delivery and ensure shifts were staffed with an appropriate mix of skills and experience.

Although the service had not undertaken an annual staff survey, staff told us they felt comfortable raising concerns with leaders and were confident that any issues raised would be listened to and acted upon.

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

Information provided by staff and leaders indicated that the organisation promoted a positive and open culture where people felt able to speak up and have their views heard. Staff spoke positively about the support they received from leaders and described leaders as approachable and responsive.

Staff told us they felt confident raising concerns about safety, practice or service delivery and were assured that any concerns raised would be listened to, taken seriously and acted upon appropriately. Staff understood the processes available to them for escalating concerns and felt able to do so without fear of negative consequences.

The service had a whistleblowing policy, which had last been reviewed in 2025. The policy outlined how concerns could be raised and how they would be investigated.

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 service had arrangements to support equality, diversity and inclusion and was a member of the Equality Register, an independent accreditation scheme that helps organisations demonstrate their commitment to fair treatment, inclusion and reducing discrimination in the workplace.

Leaders demonstrated a commitment to promoting an inclusive working environment where staff were treated fairly, with dignity and respect. The service maintained an up-to-date Equality, Diversity and Human Rights policy, which provided staff with guidance on promoting inclusive practices and preventing discrimination.

Staff understood their responsibilities in relation to equality, diversity and inclusion and recognised the importance of respecting individual differences and treating people fairly.

The service provided a Flexible Working Statement, which confirmed that flexible working arrangements were not routinely available due to the operational nature of the ambulance service. The statement explained that staff were employed to work agreed shifts and hours to ensure the safe, effective and reliable delivery of services. This approach supported workforce planning and helped ensure sufficient staffing levels were available to meet patient needs.

Despite this, we saw evidence that leaders considered individual circumstances and sought to support staff wherever possible. For example, the service had accommodated staff with caring responsibilities by adjusting working arrangements where operationally feasible.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Governance and assurance processes did not consistently identify and address environmental, equipment and safeguarding risks in a timely manner. As a result, leaders could not always be assured that systems and processes were operating effectively to maintain patient safety.

The service had established a range of governance systems and maintained a suite of policies and procedures. However, inconsistencies in oversight, record keeping and monitoring reduced assurance that risks were always identified and addressed promptly, and that the service consistently complied with its own procedures.

We identified gaps in recruitment and workforce oversight. Staff files did not always contain all the information required to demonstrate staff suitability for their roles. Records did not consistently evidence appropriate monitoring of staff health, wellbeing or fitness to undertake their duties. This meant leaders could not be assured that staff remained suitable to perform their role safely and effectively throughout their employment.

The service also lacked effective oversight of driver compliance. The Safe Driving Policy required staff to undertake regular eyesight tests; however, the policy did not specify the frequency of testing or require evidence that testing had been completed. We found annual driving licence checks had not been consistently recorded and there was no formal process establishing the frequency of driving competency assessments. Records did not provide assurance that leaders effectively monitored the physical and mental fitness of staff who were responsible for transporting patients.

Leaders did not consistently ensure compliance with operational policies. For example, the vehicle cleaning policy stated that ambulances should receive a deep clean every eight weeks; however, cleaning records did not consistently demonstrate that these deep cleans had taken place. Whilst daily and routine cleaning activities were recorded, leaders could not provide assurance that vehicles had been cleaned in accordance with their own policy.

The service had introduced an audit programme and governance meetings since the previous assessment. However, records of the governance meetings did not consistently demonstrate audit findings, identified concerns, actions taken or how learning had been embedded into practice. As a result, leaders could not demonstrate that audits were being used effectively to identify non-compliance drive improvement or provide assurance that risks were being effectively managed.

However, leaders had taken some steps to strengthen governance since the previous assessment. Policies and procedures were within their review dates, and leaders had introduced a process requiring staff to confirm they had read and understood policies relevant to their role. The service had also implemented bi-monthly governance meetings to review quality, safety, risk, incidents, complaints, staffing, training, audits and service performance. Meeting records demonstrated that leaders discussed a range of operational, quality and safety matters and maintained oversight of risks through the service's risk register. Whilst attendance by the 4 members of the leadership team was not always consistent, at least half attended each of the meetings reviewed. In addition, leaders told us they were introducing an electronic document management system to improve access to policies, procedures and governance records.

The service had a business continuity plan which identified a range of potential risks and outlined actions to maintain service delivery during disruption. This included arrangements relating to staffing shortages, vehicle breakdowns, severe weather, utility failures and IT outages. However, the plan could be strengthened further by including arrangements for more complex scenarios, such as the simultaneous loss of multiple ambulances or critical equipment failures.

Following the assessment, the service developed additional documentation to strengthen its business continuity arrangements. As these procedures were recently introduced, it was too early to assess their effectiveness in supporting business continuity.

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 provider demonstrated a strong commitment to community engagement and social responsibility. Leaders described donating out-of-date, but still sterile, bandages and needles to a local wildlife centre, helping to reduce unnecessary waste while supporting community organisations.

Leaders maintained collaborative relationships with partner organisations. Leaders met regularly with representatives from the local trust to discuss service provision, review feedback, share learning and identify opportunities for improvement. The service had also received an award from the trust in recognition of the support it provided during periods when another provider was unable to meet overnight demand. This demonstrated a positive and effective partnership and reflected the trust's confidence in the service's ability to respond to local healthcare needs.

The service actively supported local community events and ensured appropriate medical cover was available when required. Event work was primarily undertaken by bank staff, and patients who required onward care were safely transferred to waiting transport arrangements. Leaders described their involvement in a festival, where road closures restricted access to the town. During these periods, the service remained operational within the closure zone, responding to local incidents and liaising with the local ambulance trust to coordinate their presence and support.

The service also engaged with local schools and youth groups, including Scout organisations, to promote awareness of the ambulance service. These visits provided children and young people with opportunities to meet staff, learn about the role of ambulance services and explore ambulances in a safe and educational environment.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The service demonstrated a willingness to learn and improve; however, opportunities for improvement were not always identified through existing monitoring and oversight processes. For example, gaps relating to driver compliance, vehicle cleaning records and equipment checks had not been identified through routine auditing arrangements

However, since the previous assessment, the service had made some positive improvements, including the introduction of regular governance meetings and a process requiring staff to confirm they had read and understood policies relevant to their role. The service was also introducing an electronic document management and compliance system to strengthen monitoring arrangements. While these developments were positive, further work was needed to embed robust systems that consistently identified learning opportunities and support continuous improvement.