Gateshead Hatzola Ambulance Station Also known as Gateshead Hatzola

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were now safe and protected from avoidable harm.

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 have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff we spoke with knew how to report serious incidents or adverse events, however there had been none specific to the service within the last twelve months. Staff understood the duty of candour, they were open and transparent and would give patients and families a full explanation if and when things went wrong.

The registered manager undertook regular audits of calls to the service, and also of patient report forms completed by responders. Audits detailed the circumstances of the response, findings and learning points, and were used in feedback.to staff.

There was evidence that changes had been made as a result of feedback, such as a requirement to include evidence of stabilisation recorded on the patient record form, responders to always keep a second and fully charged radio battery in their tabard pocket, and the first responder on scene to always take both kits in to the incident.

We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff involved all necessary healthcare services to ensure patients had continuity of safe care. A standard operating procedure (SOP) ensured there was a clear pathway for requesting local NHS ambulance trust assistance when responders identified a higher category on attendance (categories C1 and C2).

The service had developed a handbook detailing local contacts, such as doctors, dentists, pharmacists, GP surgeries and minor injuries units. Pre-alert telephone numbers were available for local hospitals, the urgent care team and the NHS ambulance trust dispatch. Further information had been included on the normal parameters for blood pressure, blood oxygen levels and pulse rates at different ages. These were complemented by guidance on the Glasgow Coma Score (GCS), the Mental Capacity Act, the National Early Warning Score, and Manchester Triage pathways for trauma, medical and mental health. This enabled responders to identify and collect relevant information about patients before handover to local services where necessary.

The service had also developed a patient report form which enabled responders to record and handover patient information and medical history to other services where necessary. This electronically recorded the nature of the emergency, presenting complaint, response and handover times, a primary survey and initial examination and observations of the patient (history, treatment, advice given, oxygen levels, blood pressure, GCS). Safeguarding notes and the overall risk level were also recorded for handover.

We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, and we make sure we share concerns quickly and appropriately.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Although the service provided a volunteer ambulance service primarily to the Jewish community, it also provided the service to the non-Jewish community when contacted to do so. Responders had received mandatory training in equality, diversity and human rights.

All responders were trained to Safeguarding Children Level 3 and Safeguarding Adults level 3.

We were given examples where staff had identified and reported potential safeguarding concerns to the designated safeguarding lead (registered manager), and appropriate action taken. Responders also raised issues with the safeguarding lead which were identified as welfare concerns but did not meet the threshold for reporting to the safeguarding authorities.

The service did not use restraint techniques.

We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Call handlers and dispatchers identified the care and treatment needs of patients during their initial call, including their location, nature of the emergency, presenting complaint, medical history and medication, and communication or advocacy needs.

Responders then identified further care and treatment needs ‘on arrival’, such as patient history, patient condition on examination, and identified treatment in consultation with the patient or next of kin if applicable. Observations were recorded and further advice given to the patient where necessary. Safeguarding concerns, if any, were recorded and an ‘overall risk level’ assessed. The patient or next of kin signed off the treatment given.

During our assessment we accompanied responders to two incidents and received overwhelmingly positive feedback of their experience.

We detect and control potential risks in the care environment and make sure that the equipment, facilities and technology support the delivery of safe care.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service used one fully equipped ambulance kept within a secure and monitored compound within a local car park.

Daily checks of the ambulance were carried out confirming the road worthiness and maintenance of the vehicle. These included checks of the physical condition of the ambulance and a check of the equipment utilised on the vehicle, such as Oxygen and Entonox cylinders, medication, defibrillator, carry chair, mobile phone and vehicle radio. All equipment was maintained and checked at a nearby ambulance station through an agreement with the local NHS ambulance trust, including a vehicle service and MoT.

Daily checklists of the ambulance were uploaded to the service systems electronically and audited through the ambulance check daily record.

We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

We scored the service as 3. The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service was staffed by volunteer responders and operated 24 hours a day, 365 days a year trained to First Response Emergency Care Level 4 (FREC4).

A policy was in place to ensure that suitable volunteers were recruited and inducted. Induction received was appropriate to their role and satisfactory completion depended on passing relevant assessments. On successful completion, candidates received familiarisation with equipment and relevant policies, protocols and operating procedures, followed by shadowing during a probationary period.

One member of staff acted as the registered manager and oversaw all staff, responders and dispatchers. A clinical director was in place to provide medical advice. Two members of staff were employed as call handlers and dispatchers.

The service had developed a comprehensive programme of mandatory training for responders and staff were up to date with appropriate mandatory training. Training was appropriate for the patient group using the service and included for example, infection prevention and control, resuscitation, moving and handling, and safeguarding. Further complementary training sessions such as pre-hospital care for lacerations and minor amputations had been delivered by clinical experts from local NHS hospitals.

We assess and manage the risk of infection, detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

All cleaning records were up to date, ‘clean’ stickers were in date and demonstrated cleaning was completed daily. Audits showed there was a 100% compliance with hand washing requirements.

Records showed a deep clean was carried out on the ambulance on a twice-monthly basis and additionally when needed, by an external commercial cleaning company. Infection prevention and control monthly audits were carried out on the ambulance bay area, the equipment stores and general purpose areas.

We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happen.

Summarise your findings here using the topics below:

Although the service did not use controlled drugs, the service had a policy in place covering the management of medicines used (Oxygen, Aspirin, Salbutamol and Entonox). These medicines were administered in accordance with a SOP developed by the clinical director. The SOP covered the correct storage of medicines on the ambulance and within the service premises, administration, documentation and waste management.

Regular medication audits had been completed, including temperature checks of the store room at the ambulance station.