The Care Quality Commission
  • Ambulance service

Archived: Wealden Ambulance Services

Overall: Requires improvement read more about inspection ratings

Unit 10, Vantage Point, North Trade Road, Battle, TN33 9LJ (01323) 486888

Provided and run by:
Ms. Judith Appleton

Important: This service was previously registered at a different address - see old profile

All Inspections

02 February 2021

During an inspection looking at part of the service

Wealden Ambulance Services is operated by Ms Judith Appleton. The service provides a patient transport service.

Following the previous inspection on 10 December 2020, we suspended the registration of this service for eight weeks, to allow the service to make necessary improvements. This inspection was carried out to assess the changes made while the registration was suspended. We inspected this service using our focused inspection methodology. We carried out the announced part of the inspection, giving 48 hours’ notice on 2 February 2021 and lifted the suspension of the registration with the Care Quality Commission. The provider had employed a consultant who had an expertise in supporting providers to gain compliance with Care Quality Commission regulations.

To get to the heart of patients’ experiences of care and treatment, we normally ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? During this focused inspection we looked at part of the domain of safe and the whole domain of 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.

We found that:

  • The inspection action plan had been reviewed in detail and had been used to drive improvement.
  • All staff had completed a comprehensive suite of mandatory training. The training was in line with skills for health training. The training included mental health training. The provider had completed a training matrix to monitor staff compliance.
  • Working with the consultant, the provider had developed a risk register which identified the current risks within the service. Each risk had a weighting and was a standard agenda item on the management meeting.
  • A patient acceptance criteria and assessment process had been developed.

However:

  • Policies needed further improvement to ensure they reflected current national guidance and the activity of the service.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South), on behalf of the Chief Inspector of Hospitals

08 December 2020

During an inspection looking at part of the service

Wealden Ambulance Services is operated by Ms Judith Appleton. The service provides a patient transport service.

We inspected this service using our focused inspection methodology. We carried out the announced part of the inspection, giving 48 hours’ notice on 10 December 2020.

To get to the heart of patients’ experiences of care and treatment, we normally ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? During this focused inspection we focused on part of the domain of safe and the whole domain of 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.

Following this inspection, we suspended the registration of this service for eight weeks, to allow the service to make necessary improvements. We found that:

  • There was very little improvement since our last inspection in January 2020
  • The inspection action plan submitted to CQC had not been updated or used to drive improvement. Therefore, there was little progress made on the must do and should do actions identified on our January 2020 inspection
  • Staff training was not always undertaken. Staff did not receive training to the standard needed to enable them to meet the needs of those they cared for. An example of this included (but was not limited to) providing a service to patients detained under the Mental Health Act.
  • Safeguarding training, systems and processes did not protect people from the risk of abuse. Safeguarding notifications were not submitted to CQC
  • There were no systems or processes to monitor governance, risk or monitor quality in the service
  • There was insufficient leadership in the organisation.

However:

  • It was clear from our interactions with staff there was a commitment to improve the service.

Name of signatory

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South), on behalf of the Chief Inspector of Hospitals

12 December 2019 to 14 January 2020

During a routine inspection

Wealden Ambulance Services is operated by Ms Judith Appleton. The service provides non-emergency patient transport services that help people access healthcare in England.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 14 December 2019, along with unannounced visits to the service on 12 December 2019, 23 December 2019 and 9 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.

The main service provided by this service was patient transport services.

We have not previously rated this service. We rated it as Requires improvement overall.

We found the following issues that the service needs to improve:

  • We found medicines were not always securely stored. The service’s controlled drugs licence had expired in October 2019, although the service had applied for renewal in January 2020.

  • Not all staff had a valid ‘disclosure and barring service’ (DBS) check prior to working with patients.

  • Although the provider had a verbal contract, they did not have a formal contract or service level agreement with an external provider of level 4 safeguarding advice.

  • Records of vehicle cleaning were not always recorded by patient transport services crews.

  • Although there was a procedure which staff could explain, there was no formal policy or procedure for care of deteriorating patients.

  • Staff told us they were not always provided with basic information about patients.

  • Although all vehicles were audited annually, including patient transport services vehicles, prior to the events season, these were not always effective, as we found out of date dressings and equipment on vehicles.

  • The service did not have a formalised system for monitoring patient outcomes.

  • Staff had not received mental health awareness training although the service were transporting increasing numbers of patients with mental health needs.

  • Staff did not have access to regular supervision or team meetings.

  • We identified risks that were not identified on the risk register. The risk register recorded one risk relating to infection prevention and control; but actions the service had taken to mitigate the risk were not recorded on the risk register.

  • Due to issues with the directorship of the service, managers did not have access to computer systems and passwords at the time of the inspection, although managers could access patient and booking information.

However, we found the following areas of good practice:

  • The service had high compliance rates for staff mandatory training and staff had met most of their targets.

  • The service had clear processes and systems to help keep vehicles and equipment ready for use. This included yearly MOTs, regular servicing and maintenance.

  • All staff had undertaken in-house induction and mandatory training in key areas to provide them with the knowledge and skills they needed to do their jobs.

  • The service had up to date policies to support staff.

  • Staff treated patients with compassion and empathy.

  • The service acted to meet patients’ individual needs.

Following this inspection, we told the provider that it must take some actions to comply with the regulations 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 notice(s) that affected patient transport services. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South), on behalf of the Chief Inspector of Hospitals