Transcare Secure Services - Birmingham

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes

We reviewed the person-centred care; care provision Integration, and continuity, care provision, Integration, and continuity; providing Information listening to and involving people; equity in access; equity in experiences and outcomes and planning for the future as part of the responsive key question. We found the key question responsive had improved to good. The service planned care to meet the needs of 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. The service provided care and treatment for patients 24 hours a day to meet the needs of those using the service.

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.

We were unable to evidence observations of interactions between patients and staff as over the 2 days of the assessment the service did not have any transfers booked. However, the service identified on their transfer request form if a patient were able to be involved in their decisions of their care, this is identified under the section of if the patient had capacity and were able to make decisions about the care provided. The service gained feedback from patients where this was appropriate, and the feedback stated that this was a good service and were happy with the care they received. The service did not have any waiting lists and no cancelled journeys. The service was only currently having between 7 and 10 calls a month.

Staff we spoke to at the service told us that at the booking stage they captured any additional needs of patients such as translator, a chaperone or social worker to attend the journey and any dementia and learning needs. Staff also told us where possible they would adjust the service vehicles if this was requested by the patient or change the seating arrangements of the staff in the vehicles. Staff completed training to enable them to provide patients centred care. Training topics included dementia and learning needs, autism and equality awareness. Staff also completed an introduction to the development of children and young people, which scored a 100% completion rate. Training for health and safety for supporting children and young people, had 1 staff member whose training had expired and 1 staff who had a date to complete this training. This training had been identified to ensure the staff had a good understanding of how to support any person under the age of 18 year of age. Staff had also completed eating disorders training which score 100% of compliance and equality, diversity and inclusion training for which compliance was 97.29%.

We were unable to evidence observations of interactions between patients and staff as over the 2 days of the assessment the service did not have any transfers booked. However, reading the transfer reports these were written that the patient was the centre of the care package and the staff spent time getting to know the person and what things they like to gain their trust.

There were processes in place to ensure accurate assessments of patients' needs were completed to enable staff to provide person centred care. Policies were also in place to support staff with providing patient centred care which included (but not limited to) the restraint policy, supporting communication and sensory needs policy and also the Accessible Information Standard policy.

We could not collect evidence due to no patients being transferred during our assessment and therefore unable to directly ask questions related to this. Where evidence included people’s experience, we have used this in areas to support the quality statement that it related to.

Staff told us they had the skills and knowledge to support patients with mental health concerns. The service ensured that they understood and used the information, they received from services. Staff told us they understood and respected patients’ personal, cultural, social and religious needs. Services were generally planned and delivered in a way that took the needs of different patients into account.

There had been feedback received from stakeholders stating how well the service had interacted with and supported a patient who was upset and the time they took to wait for the patient to be ready for their transfer.

The service had processes in place which ensured the care being provided took into account the diverse needs of the patients they transported. The service was delivered in a way which met the needs of patients who used the service. The service regularly met with other healthcare providers who booked them to transport patients to ensure they continued to meet the needs of those they transported. However, at the time of our assessment they provided minimal services which had impacted ongoing communications with some outside providers.

Staff we spoke to explain the complaints process and that any complaints would be discussed at team meetings or displayed on the staff information board. All vehicles had information available for patients to review which explained the complaints process. Staff told us they were encouraged to give feedback and suggest improvements and that this was encouraged by the managers.

Staff told us that they received feedback from managers in relation to complaints that have been received from patients. Staff were given information on any missed service targets and actions to be taken. There was also information given at team meetings on service changes or improvements. Staff told us they had a range of tools available to them to ensure they were able to effectively communicate with patients and ensured patients received information in a format which they understood.

The service had policies and processes in place to ensure the information which patients received met their needs and where adjustments were required, these were made. The service had a policy in place which focused on supporting patients with their communication and sensory needs. However, it was noted that translation and interpretation needs did not form part of this policy. This was an area of concern identified in the inspection completed in August 2022. The service had an Accessible Information Policy in place which was last updated in March 2024.

We were unable to evidence observations of interactions between patients and staff as over the 2 days of the assessment the service did not have any transfers booked. However, patients were able to complete a feedback form, to be able to say how their care and treatment was and what they thought of the service.

Staff we spoke with were able to explain the complaints process, and said that any complaints would be discussed at team meetings or displayed on the staff information board. All vehicles had information available for patients to review which explained the complaints process. Staff told us they were encouraged to give feedback and suggest improvements and that this was encouraged by the managers.

There was a complaints, suggestions and compliments policy in place which was last amended in September 2023. This was an improvement following the inspection in August 2022. As part of the unresolved complaints section, there were details of an external organisation who would be able to support patients as well as the Care Quality Commission’s (CQCs) details. The policy indicated the CQC were unable to investigate complaints on behalf of patients. Complaints was a key part of the governance agenda. Between March and May 2024, there were no complaints received by the service. In addition to formal complaints, staff discussed stakeholder and patient feedback during their meetings. Between March and May 2024 there was 1 piece of feedback from a stakeholder and 4 pieces of feedback from patients, all reported to be positive. It was noted in the minutes for April 2024 that further exploration of ways of receiving feedback from stakeholders and patients was required.

We were unable to evidence observations of interactions between patients and staff as over the 2 days of the assessment the service did not have any transfers booked. However, the service did use picture exchange communication aids where this was required, the service also had a feedback form in the same format.

Staff told us the service provided care and treatment 24 hours a day, to patients that required transferring. Staff told us the service had an on-call system for any calls that took place out of 9-5 hours, and the service would provide support for a transfer out of hours, if this was in the best interest of the patient. Staff told us all vehicles were well equipped and suitable for transporting patients, and the service had the appropriate equipment in relation to restraint.

There were processes in place to ensure the service were available to provide transportation to patients when required. However, information collected after the assessment showed the service only completed 32 transfers between January and April 2024, this was down by 3 transfers compared to the same period in 2023. Information provided after the assessment showed the service were engaging with external stakeholders to try and increase the number of transfers completed. The service offered both planned and emergency transfers to meet the needs of patients. The 32 transfers which occurred between January and April 2024 were all recorded as emergency transfers. There had been no cancellation of transfers between this time.

We were unable to speak to patients as over the 2 days of the assessment the service did not have any transfers booked. However, patient’s access to the service would be when another provider placed a request for transfer to another service or health care setting to meet the patient needs for care and/or treatment.

Staff told us they completed a transfer request form for each patient, when the service receives a call to transfer a patient, they ensure that they gain all the relevant information about the patient to be able to complete a successful transfer. Once the service had transferred the patient to their destination the staff ensured that information is handed over to the new staff team supporting the patient.

There were processes in place to specifically seek feedback from patients who were transferred by the service to ensure they were able to make improvements where necessary. The service regularly reviewed the feedback given. Where transfers occurred and no feedback was collected, this was noted as an action to be taken away and improved on as well.