Archived: Starcross Trading Ltd T/A Bears

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 rated well-led as good. We assessed four quality statements on shared direction and culture, freedom to speak up, governance, management and sustainability and learning improvement and innovation. Managers had the right skills and abilities to run a service providing high-quality sustainable care. The service had clear governance structure and a comprehensive reporting framework in place that provided timely information on service performance.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff we spoke with told us there was a positive and supportive relationship between managers and staff at all levels within the service. Ambulance crews told us their leaders promoted a positive culture which supported and valued staff, creating a sense of common purpose based on shared values. We found an open and honest culture and staff felt supported by their managers to develop their skills and expertise. Staff were enthusiastic about their work and spoke of good teamwork in a patient-centred environment.

Staff we spoke with told us they felt they were kept up to date with any changes within the service by the management.

Ambulance staff told managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Staff said they really enjoyed working at the service and told us they felt valued by their local leader.

Staff at all levels were actively encouraged to raise concerns and told us they felt able to report concerns to their managers. The service had a diversity and inclusion policy, and leaders and managers promoted a positive culture which supported and valued staff, creating a sense of common purpose based on shared values. The service had a policy and processes for incident reporting, staff understood and demonstrated they knew how to report safety incidents. Incidents was reported, escalated and investigated, learning from incidents was fed back through regular team meetings.

The service had a communication bulletin that was published every six weeks. This provided managers with an opportunity to communicate a range of different things to staff, including any key concerns, feedback from any learning from incidents and policy updates.

We were told the service employed paramedics, ambulance drivers who were trained as emergency care technicians. Staff driving licences were checked with the Driver and Vehicle Licensing Agency (DVLA) as being valid and appropriate for the class of vehicle they were driving when the staff member was appointed. Staff we spoke with told us all staff were required to complete Disclosure and Barring Service (DBS) checks and overseas applicants were checked with the UK Border Agency for their right to work in the country. Managers identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge. Managers made sure staff received any specialist training for their role such us blue light driving, intermediate resuscitation etc. Staff told us they had the opportunity to discuss training needs with their line manager and were supported to develop their skills and knowledge.

Staff we spoke with understood and respected the personal, cultural, social and religious needs of patients and how they may relate to care needs. This included beliefs and cultural differences.

The staff rota was designed to reflect the variable patterns of demand across the day and week. There were enough staff to cover planned absences including annual leave and sickness absence. In the event of an unexpected surge, the service was able to move crews from less busy services and sites to support the site experiencing the increase in demand. Staff rotas were done on a monthly basis, these were sent to staff a month in advance, so they knew what shifts they were working. The was a process of calculating staffing numbers and we saw that actual staffing levels reflected the planned numbers.

Staff and patients were encouraged to provide feedback and raise concerns without fear of reprisal. Staff confirmed there was a culture of openness and honesty, and they felt they could raise concerns without fear of blame. They were aware of the whistle blowing helpline and Freedom to Speak Up champions within the service as an alternative route to raising concerns. Staff felt supported by their managers to develop their skills and experience. Staff of different grades we spoke with gave examples of how they were encouraged to develop through training, study days and attending conferences.

The service collected and analysed electronic and paper-based information to monitor safety, quality and performance. Staff told us they could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. Staff used agreed systems and processes to identify and escalate relevant risks and issues and identified actions to reduce their impact. The service had plans to cope with unexpected events such as loss of power or breakdown of vehicles.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There was a robust and embedded clinical governance structure and culture of identifying and managing risk. Feedback from staff and leaders was that the provider operated effective governance processes throughout the service. Staff we spoke with were awareness of the service’s governance processes and knew how to escalate their concerns. Staff told us they felt there were very good lines of communication within the service. This included several meetings where staff could voice their concerns and where feedback was provided to staff on actions taken.

Staff we spoke with told us they worked well together as a team; they said the service had a positive and respectful atmosphere, which promoted teamwork and putting patients first and meeting their needs.

Leaders and teams used systems to manage performance, escalate and manage risks and issues effectively, mitigating their impact on the service and users. . . We saw the service had a risk register which included potential risks of harm to patients and staff. This was reviewed monthly as part of the business continuity plan. There was a programme of clinical audits across the service, which meant senior staff could monitor compliance with safety standards and take any necessary actions.

The service had plans to cope with unexpected events such as loss of power or breakdown of vehicles.

The service had a clinical governance team, who were all clinical, who provided clinical support 24 hours a day, seven days a week. The clinical governance team were responsible for a range of activities including unannounced inspections, audits, medicines management and provide mandatory training updates to staff. They also attended the monthly clinical governance meetings incidents and performance.

There was a risk register in place which provided details of the risk, a risk rating and details of the actions the service were taking to mitigate the risk.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Leaders encouraged innovation and sustainable ways of providing service. All staff we spoke with were committed to continually learning and improving services. Managers had a good understanding of quality improvement methods and the skills to use them. Leaders and staff continued to participate in recognised accreditation schemes such as paramedic training and projects to improve practice and the patient experience.

Staff were committed to continuous learning. They told us they were supported by their managers to develop their leadership skills and access development opportunities.

To improve their performance, the service had developed a mobile application which staff could access on the service’s portable devices and their personal mobile phones to enable easy and fast access to work assignment and rotas. The application gave staff access to a range of information including policies and guidelines, the communication bulletin, service announcements and patient request form (PRF) audits. Staff using the application could also access information about the jobs they had been allocated and input their time sheet information. The service stated it was planning to further develop this application so that all BEARS activity runs via the application. However, at the time of our inspection we were not provided with timescales for this development.