Hardcore Medical & 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

Hardcore Medical Ambulance Service (HMAS) is a private ambulance service based in Leicester and Cheshire registered for emergency and urgent care services with an ad-hoc contract with the Northwest Ambulance service (NWAS).

HMAS was formed in 2010 and provides services using emergency care & utilises ambulances designed for emergencies, patient transport and medical event journeys.

The service was last inspected on 21 August 2018 and has new contracts in Cheshire with a recently set up HMAS storage facility.

HMAS also has a separate arrangement with a local NHS hospital trust to provide patient transport services which were not reviewed as part of this assessment.

We carried out this assessment because we received information giving us concerns about the safety and quality of the services provided. We carried out a short notice announced site visit on 3 September 2024 and the assessment continued to 18 October 2024.

We rated the service as good because:

The service did use effective systems and processes to store medicines, and managed cleanliness & infection prevention well.

Vehicles and equipment were well-maintained, the service demonstrated they had effective arrangements and processes in place to monitor the safety and upkeep of consumables, equipment and vehicles.

The service did manage patient safety incidents well.

Leaders did always demonstrate the skills and abilities to run the service.

Leaders did operate effective processes for governance, information management and the management of risk, issues and performance. Policies were relevant, appropriate and up to date and did reflect up-to-date national guidance.

The service had robust recruitment processes, to ensure all staff were up-to-date mandatory training and additional training to work with the patient group.

We looked and assessed HMAS against a range of quality statements in the key questions, safe and well-led.

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.

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff told us they were involved in the communications, sharing ideas and supportive of changes following feedback from partner agencies and service users.

Staff had 360-degree appraisals. Leaders sent out communications once a week to all staff and a newsletter twice a year, in addition to using an electronic system to ensure teams were connected to all communications and messages.

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff and leaders told us and showed us their services strategy and explained what they hoped to achieve in the future. HMAS service leaders run the service to value-based objectives and aims. The leaders had shared projects and plans for the service. We reviewed evidence including meeting minutes, plans and feedback from staff which had described the leaders as being compassionate and supportive.

The service has encouraged diversity and inclusivity with their employees which is underpinned with policies and guidelines.

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.
Staff and leaders told us that they have access to a freedom to speak up representative, who is external from HMAS management.

The service displayed posters, emails and policies, and a poster relating to the Freedom to Speak Up and staff were encouraged to review the information.

Leaders supported staff to make confidential contact with the Freedom to Speak up representative who is independent to the service and leaders.

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs.
Feedback from staff and leaders
Staff and leaders told us the service had advertised internal opportunities for staff to take on additional roles to champion their workforce equality, diversity and inclusion, mental health, and safeguarding for the service. However at the time of assessment leaders told us there had been a lack of staff engagement in this initiative.

Leaders fedback the service they had focused on workforce equality, diversity and inclusion and as such had advertised for staff to undertake a 'champion' role to support this. At the time of our inspection, staff uptake had been low and leaders had not identified why this was.

HMAS were not able to demonstrate they were achieving staff involvement and progression with EDI due to the lack of staff willing to take on EDI roles. Staff had access to a service policy on equality, diversity and inclusion and we found staff EDI training compliance showed us 72 of HMAS staff were 95% or above compliant with mandatory training which included Anthony McGowan training

HMAS used language and telephone translations service, and a multiple language phrase book in addition to google translate, and some staff are trained in Macaton.

Staff and leaders told us of their risks at the time of inspection, how they have applied for International Organization for Standardization (ISO), and they have the template for use. Leaders and staff told us they recognise that the highest risk is the inability to predict their work contracts, actions in place to ensure post shift check lists, incidents and times of delays. Occupational stress and psychological risk to staff is also listed. HMAS have an ongoing audit of patient record forms (PRF), in the event of any learning from omissions or amendment to the format of the PRF being identified action plans were created this was evidenced with a change to the PRF to include extinct of life information. Leaders were able to evidence lessons learnt and changes to practice based on governance and risk including secure storage of patient record forms.

Staff and leaders told us of their current risks. Leaders told us they had applied for International Organization for Standardization (ISO).

HMAS had an ongoing audit of patient record forms (PRF), in the event of any learning from omissions or amendment to the format of the PRF being identified action plans were created this was evidenced with a change to the PRF to include extinct of life information

Leaders showed us their business continuity policy, the leaders on call rotas and major incident policies. The service had clear governance and management processes in place. Policies are reviewed annually, although were reviewed sooner if things change. Any changes would be communicative effectively with staff and stored on the knowledge bank. The service had a process where initially staff sign to say they have read all policies, and they are currently working on process to evidence staff have read and have the appropriate competency to work to the services policies.

 

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We did not collect sufficient evidence to comment on people's experience for this quality statement. We were unable to evidence this quality statement.

Staff told us that they supported and helped a night-time charity supporting women, children and vulnerable people.

Staff and leaders told us they had partnership working with NHS ambulance providers, the integrated care board (ICB) who they worked with at times operational pressures. Feedback from NHS ambulance service and nhs hospital provided evidence of positive care and relationships.

HMAS had a process of reviewing safeguarding outcomes shared with them from the NHS providers

Good – This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We spoke with staff and leaders who told us about learning, improvements and innovations within HMAS. Staff told us information is available through the HMAS “connect team” internal communication dashboard which contains information for employees including job schedules, policies, staff update board, qualifications, staff can review their own individual personnel folders.

HMAS used language and telephone translations service, and a multiple language phrase book in addition to google translate, and some staff are trained in Makaton.

Staff told us this had been voluntary work included supporting welfare and medical care. Staff told us they had supported and worked with the local street pastors.

Leaders told us they provided free first aid to local learning disability school and businesses.

HMAS had a workforce planner and process to recruit which included the correct processes and checks took place. Following recruitment, all employed staff completed an induction and a disclosure and baring service (DBS) application as the service can treat children. HMAS had a clear process in the event of issues being identified from a staff members DBS check. We reviewed 5 staff records, and, in all cases, the appropriate recruitment process had been completed.
HMAS had an audit planner dashboard, and they rated their risks by colour with the greatest risk rated as red, amber as medium and green as low (RAG) on an electronic system. Results from this audit influences the service which included amending or introducing training, action plans and continued audit to learn and improve the service.

We found results from patient record (PRF) form audit in August 2024 showed the service as being green and compliant without any specific issues related to the compliance of completing PRF.

Audits included clear desk audit, safe storage of patient record forms, the International Organization for Standardization (ISO), fire safety, business continuity, medical waste disposal, reporting of injuries,

At the time of inspection, we found the service did not have a process to monitor subcontractors training compliance, continued professional development and the use of their controlled drugs. Following the onsite inspection HMAS has implemented processes to gain assurance for the safe monitoring of both issues.