Archived: Paramed Ambulance Service Limited

We rated the service as inadequate because:

Staff did not receive effective training in safety systems, processes and practices and there was insufficient attention to ensure staff received safeguarding training. Staff did not receive training on how to recognise if patients deteriorated during the ambulance journey. The service did not make sure staff were competent for their roles.

The service did not always control infection risks well. Standards of cleanliness were not maintained. The maintenance and use of equipment did not keep people safe and ambulance safety was compromised. The service did not have effective systems and processes to ensure medicines were always prescribed and administered safely.

There were limited risk assessments carried out for people who were conveyed by the service. Staff did not keep detailed records of patients’ care and treatment when they provided patient transport services. There was limited use of systems to record and report safety concerns, incidents and near misses.

The service did not have enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. The manager did not complete all necessary employment checks to make sure staff were of good character, competent and skilled to meet the needs of patients transported by the service.

The service did not provide care and treatment based on current national guidance and evidence-based practice.

Staff obtained verbal consent from patients receiving care, but this was not recorded. There were limited processes to assess and record if patients were subject to deprivation of liberty safeguards. The service was inclusive, but there were limited processes to assess and take account of patients’ individual needs and preferences. There was no evidence to show people could access the service when they needed it.

The registered manager did not have all the skills, knowledge and experience needed to run the service safely and effectively. They did not demonstrate oversight of what was happening on the front line of the service.

The registered manager did not operate effective governance processes throughout the service and with partner organisations. The service did not monitor response times so they could facilitate good outcomes for patients. The service did not use systems to manage performance and risks effectively. The service did not collect reliable data and not all information systems were secure.

However:

Staff assessed patients’ food and drink requirements to meet their needs during a long journey.

The service worked closely with systems partners, including another independent ambulance service and staff from the local NHS hospital who were responsible for patient discharges.

There were processes for people to give feedback and raise concerns about care received.