Archived: Broughton Park Ambulance Services Ltd

Broughton Park Ambulance Services Ltd is operated by Broughton Park Ambulance Services Ltd. The service provides emergency and urgent care and a patient transport service.

We inspected this service using our focused inspection methodology. We carried out the short announced inspection on 29 July 2020.

We did not rate this inspection as it was a focused follow-up.

• Since the last inspection, volunteer responders had received safeguarding training for children and adults to level three. We found that they reported concerns to one of two managers, available 24 hours a day, who had received level four safeguarding training. However, from the records we saw, safeguarding decisions made were not clearly documented as consistent with the information recorded by the volunteer responder and statutory notifications were not always routinely submitted to CQC.

• Call handlers received calls, via the dedicated phone number. Patients identified as not breathing or unconscious were immediately referred to the local NHS ambulance trust. Since the last inspection, for other calls identified as less serious, they did not triage or give advice except to call 111 or signpost to other services.

• Volunteer responders completed records of care given on patient report forms. Since the last inspection, an electronic application had been piloted where information was recorded with each responder being provided with an electronic tablet. The paper records we reviewed were not always legible or completed fully. Neither the paper record or the application included early warning scores for children and antenatal women, although; there were plans to include in the electronic version.

• Since the last inspection medicines had been removed from ambulances, except for oxygen, burns gel and skin adhesive (not for head injury use now). These were only used for first aid. Volunteer responders had received training for administration of these and there was a guideline for oxygen use.

• Since the last inspection, the incident process had been reviewed. There was an increase in reporting from 17 in 12 months, to 119 in four months. Staff were encouraged to report incidents and received feedback. Although no serious incidents had been identified there was no standardised procedure setting out how they would be investigated. Managers understood their responsibilities for duty of candour.

• In 2020 The service had reviewed policies and processes with the support of other similar organisations as well as external stakeholders in order to provide care in line with national guidance. An audit programme had been established including for volunteer responders records of care and infection prevention and control.

• Volunteer responders undertook first response in emergency care (FREC) courses either to level three or four. They received an induction and were expected to observe care with senior staff until deemed competent.

• Protocols included at least two members attended a call, however; we found six incidences were one member had attended.

• Since the last inspection, the service had sought support from other organisations and re-structured the service with a clear management structure. They had built a new building,the locationincluded a room that could be utilised for meetings and training purposes, as well as a locked store cupboard and offices where records were securely stored. Personal protective equipment (PPE) was accessible to volunteer responders. The service had been engaging with other health professionals as well as the local community to enhance and improve the service. Volunteer members were updated of changes, at meetings, however; minutes did not include regular agenda items and did not always include a list of attendees. There were plans for further improvements, although these were not fully implemented or embedded.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and some actions and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals