32 Nobel Square Also known as Specialist Medical Transport Limited

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

We assessed the following quality statements: learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risk, safe environments, safe and effective staffing, infection prevention and control and medicines optimisation.

We looked for evidence that safety was a priority for everyone, and if leaders embedded a culture of openness and collaboration. We checked that people were safe and protected from bullying, harassment, avoidable harm, neglect, abuse, and discrimination. We also checked people’s liberty was protected where this was in their best interests and in line with legislation.

At our last assessment we rated safe as good. At this assessment, the rating has remained good. This meant people were 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.

During our inspection, we saw a positive and proactive safety culture. Staff were open and honest. They listened to safety concerns, investigated events, and learnt from them. This helped the staff improve and maintain good practices.

Staff had access to incident and complaints policies. Staff understood the importance of reporting and learning to ensure safety and improvements. Staff understood Duty of Candour.

Staff managed safety incidents together, internally, and externally with partners. For example, an incident where a patient had been given medication that was queried by the local hospital. This led to a hospital complaint due to different guidelines. The local NHS Ambulance Service and the hospital investigation lead worked together and confirmed the correct procedure was followed. This showed the importance of following guidelines and working together to ensure safety.

Staff told us they received feedback from incidents and concerns. We saw sharing of information and feedback from incidents on the team shared mobile phone app groups. This process ensured standards were maintained and promoted shared learning and continuous improvement.

Leaders demonstrated a commitment to safety by collaborating with partners to establish and maintain safe systems of care. Partner agencies carried out their own local audits of the service to assess safety standards. For example, there had been a Home Office controlled medicines audit and local hospitals ambulance service audits.

Safety was a priority throughout people's care journeys, ensuring continuity of care. The collaborative approach involved staff and other partners in care, including during referrals, admissions, and discharge processes.

Staff were aware of risks across care journeys and planned and organised care and support with people, partners, and communities to ensure continuity. Operations were managed across multiple sites with consistent management attendance and supervision of control rooms. The use of an electronic system for bookings and invoicing streamlined processes, ensuring efficient and effective service delivery.

Staff worked with people and healthcare partners to understand what being safe meant to them. Staff focused on improving people’s lives while protecting their right to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. Concerns were shared quickly and appropriately.

Staff had access to procedures for raising safeguarding concerns. For example, staff could access the NHS app or use a QR code on Safeguarding Reporting Forms. Policies were clear and up to date. A 'Road Map' for safeguarding was printed on the back of Daily Log Sheets for easy reference, including a QR code.

Staff raised safeguarding concerns promptly with a single point of contact based at hospitals they were contracted to work with. The single point of contact would then contact the relevant safeguarding teams.

People were educated on what being safe meant and how to raise concerns if they felt unsafe. Incident report forms and safeguarding reports were used to document and address concerns. Regular risk analysis and the use of force forms for secure patients helped manage risks effectively.

Staff took immediate action to keep people safe, including working with partners like Local Authority Designated Officer (LADO) and the police.

Staff had a clear understanding of the Deprivation of Liberty Safeguards (DoLS). Staff were knowledgeable about DoLS and ensured it was applied correctly.

Safeguarding systems and practices upheld human rights and protected individuals from discrimination. People were informed about their rights under the Mental Capacity Act 2005 and the Equality Act 2010. Training and resources helped individuals understand their legal rights and protections.

Staff took specific measures to safeguard people with mental health considerations. Secure transfers were arranged for Child and Adolescent Mental Health patients. Staff employed for these jobs were assessed as appropriate determined by skills and training.

Staff ensured they followed safety protocols. For example, staff were required to use blue lights for forensic patients to navigate traffic safely. Staff were supported by two paramedics during these transfers. Paramedic authorisation was recorded for blue lights on all occasions.

Staff worked with people to understand and manage risks holistically. Staff provided safe and supportive care that met people’s needs and enabled them to do what mattered to them. We reviewed comments and praise from a provider to crew members thanking them for the sensitive and compassionate way they had managed an anxious patient.

Leaders managed risks centrally. Staff managed incident reports centrally across all sites. The system featured drop-down menus for each category. Leaders ensured that risk themes were used from incident reporting for learning and improvements.

Risk assessments for restraints involved evaluating the necessity and safety of using restraints on people. Only appropriately trained staff would carry this out. Staff stated they would not use restraint unless necessary and would always use the least force as a first option.

The governance lead worked collaboratively to ensure all relevant people were involved in risk management. For example, overseeing medicines management and staff compliance in medicines management. This role included supervision from registered paramedics and the Medical Director.

Staff detected and controlled potential risks in the environment. Staff ensured equipment, facilities, and technology supported safe care.

Staff were employed specifically to oversee the environment including vehicle maintenance. The systems were robust, and the environments were well maintained.

Staff had access to a laundry area which was tidy. There was a washer and dryer, and a new sluice. Staff explained further planned developments, including a false floor to create a training area and additional offices, plus designated inside ambulance bays.

Staff told us about learning and improvements from an onsite fire. There had since been a rebuilding/refurbishing of the Basildon site. Staff now had access to powder extinguishers, thermal cameras, and a full alarm system.

Staff ensured equipment safety. All wheelchairs underwent rigorous testing. Staff manually managed cell use audits and conducted their own risk assessments. However, at both sites we saw a fire extinguisher needed servicing, and 2 first aid kits were out of date. At the Devon site, oxygen storage needed clear labelling.

Staff engaged with stakeholders to ensure that appropriately trained personnel and proper equipment were deployed. For example, a bariatric (specially designed vehicle to transport severely obese people) ambulance equipped with extra padding and lifting gear was available, and bariatric-trained staff were used to transfer people above a certain weight.

Staff used a patient-centred approach for people living with dementia. Regular risk assessments identified and mitigated potential hazards.

Staffing availability and medicine-related risks were tracked. Incident reports and deep cleans for satellite locations were managed centrally. Incident reports were available electronically, and updates were shared using WhatsApp groups.

Leaders investigated complaints, including inappropriate use of blue lights. Staff used an electronic monitoring system for blue light use. Vehicles were tracked, and blue light activations were logged with no discrepancies.

Staff were informed through shared mobile phone app groups links to policies and procedures. They had access to Language Line for translation services, and visual communication books were on order. These measures ensured equipment, facilities, and technology supported safe care.

Leaders made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. Staff worked well together to provide safe care that met people's individual needs.

Leaders employed appropriate numbers of staff. Staff we spoke with told us they had no concerns about staffing. The staff skills mix was also appropriate with paramedics and technicians employed.

Staff complied with mandatory training. Staff told us they had additional training opportunities to help them in their roles.

Staff received supervision and appraisals. There was an electronic system that flagged non-compliance and when updates were due.

Staff received a full induction and were assessed for competency. Additional support was given to those needing it. Non-compliance and competency issues were escalated, and some staff were suspended from full duties until they demonstrated competency.

Staff were trained up to Level 3 in safeguarding in children and adults through online courses provided by a recognised provider, ensuring staff knew how to take appropriate action.

Staff received Prevention and Management of Violence and Aggression (PMVA) training, which included the use of de-escalation and restraint. Staff undertook dynamic risk assessments to ensure least restrictive practice.

A human resources lead managed an electronic system for statutory and mandatory training. This system flagged renewals and sent due dates through email reminders. Non-compliant staff were taken off duty until they completed the required training. This approach ensured prompt and effective risk management.

All staff received specific nationally recognised training, such as Level 3 Certificate in First Response Emergency Care (FREC 3). This is a regulated and nationally recognised qualification.

Staff were employed in accordance with the Rehabilitation of Offenders Act. Leaders conducted risk assessments for individuals with flagged records on their Disclosure and Barring Service DBS checks and excluded high-risk offenders from recruitment. Leaders also carried out random drug checks to ensure staff compliance and safety.

Staff assessed and managed infection risks effectively. Staff detected and controlled the risk of infection from spreading and where appropriate promptly shared concerns with appropriate agencies. A general walk-around confirmed all areas were clean and tidy.

Our observation showed good infection prevention control. Equipment and vehicles were clean and tidy. Staff were well presented with clean uniforms, adhering to bare below the elbow guidelines.

There were no hand sanitisers carried by staff or on the vehicles. This was promptly rectified by a leader. One vehicle had a hand sanitiser, and wipes were available.

Staff made sure that medicines and treatments were safe and met people's needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

The service's medicines management policy covered all aspects of medicine management, including ordering, storage, administration, and disposal. Medical gases were safely stored, and a grab bag was available for paramedics and technicians when transporting people.

Paramedics and technicians recorded medicine administration electronically on patient care records. The provider collaborated with local NHS ambulance services, using relevant policies, guidance, and patient group directions. Controlled drugs were securely stored, with ongoing process reviews aimed at improving governance and accountability.

We reviewed the locker system used for safe storage that we saw last time - this was now operational and provided a safe, secure, and monitored storage/access to medication, communications, keys, and kit.