Archived: Starcross Trading Ltd T/A Bears

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

We assessed four quality statements. There was a positive learning safety culture where events were investigated, and learning was embedded to promote good practice. The service had enough staff with the right qualifications, skills, training and experience to keep people safe. All staff had completed safeguarding training on how to recognise and report abuse and they knew how to apply this training. The service had suitable and well-maintained equipment. Staff kept detailed records of patients’ care. Records were clear, up-to-date and easily accessible. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with staff. Staff worked with NHS partners to establish and maintain safe systems of care, in which safety was managed, monitored and assured.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us the service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff. People we spoke with told us they knew how to make a complaint or raise concerns and felt comfortable doing so.

Staff understood and had access to the complaint’s policy and procedures to guide them in managing complaints.

Staff told us they understood and had access to the complaint’s policy and procedures to guide them in managing complaints. Staff told us they were expected to report and escalate any concerns in line with the service’s policy. If the concern was not resolved immediately by the member of staff, a senior member of staff would contact the patients or families to discuss their concerns with the aim to resolving the matter.

Staff told us there was a positive culture within the service where their views were respected and valued. Staff said they really enjoyed working at the service and told us they felt valued by their local leader.

Most staff we spoke with told us the service was a positive place to work and that managers promoted an open culture. Staff felt supported and respected and told us they were encouraged to raise concerns and felt been listened to and valued.

Processes were in place to ensure incidents were reported and investigated. The incident investigation reports reviewed during our assessment included a detailed chronology of events, with evidence of learning, and actions identified to address any areas of concern. Leaders monitored data on incidents through monthly governance reports which was discussed at the clinical governance meetings held monthly.

Complaints were discussed at management meetings and there was a system for capturing and learning from complaints.

The service produced monthly activity reports including incidents reports and service performance measures, and these reports were monitored and discussed in staff meetings.

People who use the service told us they could access the service when they needed it and did not have to wait too long for their journey. Senior managers told us the service managed patient safety incidents well.

Staff told us their training needs were met, and managers were always willing to support their development. Staff told us they had been supported to access training courses relevant to their needs and the need of the service. At the time of our assessment, 95% of staff had completed their mandatory training and appraisals. Senior staff told us new staff received induction and had competency folders which were signed off by senior members of staff once a competency had been achieved. Ambulance crew we spoke with confirmed to us that they had induction and competency assessments before been allowed to work independently.

The service’s contracts were obtained through a tendering process. The service held some longstanding contracts with London and regional NHS hospitals, as well as recent contracts that had been obtained. We were told by the senior management staff that every month the service would have a meeting with their clients, some of which would take place monthly and others which took place every two months. Meeting minutes were provided as part of their evidence to support these meetings.

New staff received a comprehensive induction and had competency folders which were signed off by senior members of staff once a competency had been achieved.

The service planned care to meet the needs of local people and made it easy for people to give feedback through patient survey and comments received from service users. The service had incident reporting tool. Staff told us they reported incidents and near misses and knew how to raise concerns using the provider’s electronic incident reporting tool in line with the provider’s incident reporting policy. Managers investigated incidents and shared lessons learned and feedback with the team at team meetings.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us the maintenance and use of vehicles and equipment kept people safe and staff were trained to use all the equipment’s in the vehicles. Staff managed clinical waste well. Staff completed and updated risk assessments for each patient and removed or minimised risks. Staff identified and quickly acted upon patients at risk of deterioration.

Staff told us they had access to all the equipment they needed and guidance or instructions for using equipment. People we spoke with told us all vehicles’ checks were up to date, were well maintained and cleaned thoroughly. Drivers conducted daily vehicle safety checks using their personal electronic device to ensure the vehicle and equipment were safe to use. Staff also conducted daily safety checks of specialist and emergency equipment. We saw the check sheets which showed staff fully completed vehicle and equipment checks before they commenced their journeys. The service kept a record of equipment maintenance which showed equipment had been maintained by the service.

Ambulance crews reported that for inter-hospital transfers and journeys for patients discharged from wards, the discharge summary and handover provided from a nurse on the ward ensured they were aware of any specific risks that needed to be mitigated.

We observed staff introducing themselves to patients. All staff wore identification badges with their name on. We accompanied two crews on different journeys. We observed a good rapport between crews and patients. We saw crews treating the patients with respect, ensuring that patient’s dignity and modesty were maintained and that they were warm and comfortable during their journeys. All vehicles we checked had an extra supply of clean blankets to support patient dignity when transporting them.

Effective processes were in place to ensure equipment was well maintained and fit for purpose. Staff told us patient risk assessments were completed by the provider requesting the use of the service. This allowed the service to allocate the correct vehicle and crew for the journey. Crews completed and updated patient risk assessments before each patient transfer to ensure all known risks were mitigated.

The service had enough ambulance staff, emergency care technicians and support staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Staff told us they received their rotas a month in advance, so they knew what shifts they were working. There were enough staff to cover planned absences including annual leave and sickness absence.

Patients we spoke with told us staff were kind and considerate when attending to patients and during journeys.

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.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.