The Care Quality Commission
  • Ambulance service

E-zec Medical - Norfolk

Overall: Requires improvement read more about inspection ratings

Unit 5 Blackfriars Court, Beacon Park, Gorleston, Great Yarmouth, NR31 7RQ (01737) 822782

Provided and run by:
E-Zec Medical Transport Services - Trading As EMED Group Limited

All Inspections

30 November 2021

During a routine inspection

Our rating of this location went down. We rated it as requires improvement because:

  • Paramedics did not always complete service user records fully.
  • The service did not complete routine patient record form audits for assurance of the clinical care provided.
  • Outcomes for patients were not always positive.
  • Managers did not always support staff to develop through timely yearly, constructive appraisals of their work.
  • Service users experienced long delays for transport following their appointments.
  • Local leadership was not fully embedded following significant changes in key management positions.
  • Leaders did not always operate effective governance processes, throughout the service.
  • Managers had not always identified risks to safety and performance, which meant mitigation of unidentified risks were not in place.

However:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse. The service controlled infection risk well. Staff assessed risks to patients, acted on them. They managed medicines well.
  • Staff provided good care and treatment, Staff worked well together for the benefit of patients and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
  • Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged with patients and the community to plan and manage services and all staff were committed to improving services continually.

29 January 2020

During a routine inspection

E-zec Medical- Norfolk is operated by E-zec Medical Transport Service Ltd. The service provides patient transport services to patients living in Norfolk and Waveney. The service has 25 ambulances which includes one high dependency vehicle which was used for preplanned transfers of patients deemed medically fit for transfers between two hospital locations. The service is operational seven days per week and largely provides transport for patients travelling to and from hospitals from their home address.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 29 January 2020.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

This was the services first inspection. We rated it as Good overall.

We found the following areas of good practice:

  • The service provided mandatory training in key skills, including safeguarding, to all substantive staff and made sure everyone completed it. Infection control risks were manged well, and there was a cleaning schedule for all vehicles. Equipment and premises were suitable for needs. Patients risks were identified and service adjustments made to meet any needs this included the transportation of patients with limited mobility and children and young people. Staff kept accurate records of treatments. There was adequate staffing to meet demands on the service. Incidents were investigated and any learning shared across the wider team.

  • The service provided care and treatment based on national guidance and evidence-based practice. Patient outcomes and performance was monitored and reviewed against service targets. Patients were supported to make decisions and staff were aware of patients who may require additional support. Substantive staffs competence was assured by regular assessments and appraisals although managers had limited oversight of bank paramedics. Staff worked collaboratively and operated a seven-day service.

  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff gave emotional support to patients and their families.

  • The service planned and provided care in a way that met the needs of local people and the communities served. It also worked with the wider system and local organisations to plan care. Individuals needs were met. Patients were able to feedback complaints or comments about the service and action was taken in response to concerns raised. The service shared learning across the organisation.

  • Strong local leadership was visible and approachable. The corporate team were responsive to concerns raised and supported staff locally. The wider E-zec vision was reflected in local plans and staff were aware of their roles and responsibilities in ensuring the vision was achievable. Staff were supported and felt valued and performance and quality was monitored. Risks were clear and actions taken to address risks were clearly recorded.

However:

  • The service did not routinely record the reasons for or actions taken when cleaning was not completed.

  • Staff did not routinely record when faulty equipment was replaced or mended.

  • Hazardous substance storage was not always clearly labelled.

  • The service used systems and processes to prescribe, administer, record and store medicines. However, these were not robust or in line with local policy.

  • The local manager did not have oversight of bank paramedics training and competence documents.

  • Risk registers were not always dated when they were reviewed.

  • Meeting minutes were not always detailed.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

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