The Care Quality Commission
  • Ambulance service

Advance Medical Transport Services Limited

Overall: Requires improvement read more about inspection ratings

Buckmore Park Race Circuit, Lower Paddock Maidstone Road, Chatham, ME5 9QG

Provided and run by:
Advance Medical Transport Services Limited

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

All Inspections

21 November 2022

During an inspection looking at part of the service

Our rating of this location stayed the same. We rated it as requires improvement because:

  • The service did not have a management system or process for the recorded assessment of risk and the services ability to meet the needs of the patient during triage at the booking stage.
  • Up to date formal agreements with client partners, did not clearly cover the services provided or agreements associated with arrangements for risk assessment and triage responsibility.
  • Medical gases were safely stored in a secure location however, gas bottles were not clearly separated.
  • The medicine policy did not reflect the current processes associated with the staff scope of medicine administration.

However,

  • The service had enough staff to care for patients and keep them safe. Staff mostly had training in key skills, understood how to protect patients from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. 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 well with patients and the community to plan and manage services and all staff were committed to improving services continually.

6 April 2022

During a routine inspection

We rated it as requires improvement because:

  • Not all staff had a clear understanding of how to protect patients from abuse. Not all daily checks were recorded, and ambulance checklists were incomplete. The service did not control infection risk well. The service did not always manage safety incidents well and learn lessons from them.
  • The service did not always monitor compliance with their evidence-based care procedures and policies. Managers did not monitor the effectiveness of the service and did not make sure staff were competent. Staff did not always support patients to make decisions about their care.
  • The service did not have a formal vision and staff were unaware of this vision. The service did not engage with equality groups. Leaders operated governance processes that were not always effective. Leaders did not collect comprehensive service information. Staff did not have regular opportunities to meet, discuss and learn from the performance of the service. Leaders had limited oversight of their service’s risks.

However, we also found these areas of good practice:

  • The service had enough staff to care for patients and keep them safe. Staff assessed risks to patients, acted on them and kept good care records. The service managed medical gases well.
  • Staff provided patients food and drink. The service met agreed response times. Staff worked well together for the benefit of patients.
  • 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. People could access the service when they needed it and did not have to wait too long for treatment.
  • 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 staff. Staff were committed to improving services.

3rd December 2018

During a routine inspection

Advance Medical Transport Services Limited is operated by Advance Medical Transport Services Limited. They are an independent medical transport provider based in Chatham, Kent. The service provides patient transport and high dependency transfers.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection 3rd December 2018.

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 is patient transport service.

We found the following areas of good practice:

  • There was a system to ensure all incidents were recorded and monitored, with learning and outcomes shared with staff.
  • Staff followed infection prevention and control procedures to reduce the spread of infection to patients. We found all vehicles were in good condition, well maintained and visibly clean and tidy.
  • Journeys were planned and considered patient safety by using information provided at the time of booking.
  • Records were clear, accurate and up to date.
  • Patients were cared for and staff were respectful to patients.
  • The service had a system for handling and managing complaints and concerns.
  • There was a positive culture within the organisation and leaders were approachable.

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

  • Staff understood their safeguarding responsibilities and what constituted abuse but staff records did not tell us if they were trained to the correct level for safeguarding children and adults. However, action was taken by the provider to improve training records after the inspection.
  • There was no risk register for the organisation or system to ensure the effective oversight of the potential risks to the service and there was no governance framework for quality assurance.
  • There were no audit processes which meant there was no way of checking protocols were being followed.
  • There was no policy for managing the use of medical gases or how to manage deteriorating patients. However, the provider issued a policy that detailed how to manage deteriorating patients after the inspection.
  • Policies and procedures were not always tailored to the company or dated, given a version number or date for renewal.
  • The service did not assess staff competence and relied on the fact staff worked elsewhere within the NHS or for other providers. There were no staff appraisals or monitoring to assess how well they were performing within their roles.
  • Paper copies were kept of incidents and risk assessments but there was no log or reporting tool to show trend analysis to prevent recurrence.
  • Consent or Mental Capacity Act training was not included in the e-learning package nor was it on the checklist of skills that staff must have.
  • There was no provision on ambulances to support people who were unable to communicate verbally or if English was not their first language.

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 one requirement notice that affected this patient transport service. Details are at the end of the report.

Dr Nigel Acheson

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