Torbay and South Devon NHS Foundation Trust

On this page

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

We looked for evidence that the service met people’s needs.

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery. The service assessed and delivered person-centred care. There were systems and processes to listen to people using the service. Staff were aware of people’s future care wishes. However, there were limited ways to access the service for people in the community. The service did not have full oversight of complaints that occurred in subcontracted services.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The booking process identified people eligible to use the service. People using the service would be reassessed when clinical needs changed to ensure they were still eligible for transport. Staff told us they reviewed complaints and reassessed, where appropriate, people who disagreed with decisions where they were not eligible for transport.

Staff were knowledgeable about the service user group they provided care for and understood the need to build a good rapport with people. Staff felt processes enabled them to respond to people’s changing needs. Patient needs were gathered at booking and the service carried out risk assessments to ensure needs were met.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up and flexible.

Managers and staff understood the needs of the service user groups for whom they provided care. Staff said training they received helped them provide care. The service’s processes included liaising with other professionals where appropriate and providing continuity of care.

During the assessment we observed staff working with other healthcare professionals to communicate patients’ needs.

The service subcontracted work to independent ambulance providers to meet demand or provide care for patients who were being transported long distances.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service had up-to-date processes and policies to provide accessible information in line with standards. There was a process to review policies and information in line with relevant standards such as The Accessible Information Standard.

There were systems to hold confidential information, and the provider had systems to ensure compliance with General Data Protection Regulation (GDPR). The provider was registered with the Information Commissioner’s Office (ICO). Staff kept patient information secure and understood their responsibilities to comply with GDPR. The service had not reported any incidents of data breaches in the 12 months prior to the assessment.

Staff received training in information governance.

There were systems to keep electronic devices secure. Confidential information was stored securely and there was a process to dispose of printed confidential waste

The service had limited oversight over complaints in subcontracted services. However, the service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service subcontracted transports to independent health ambulance providers. The service had a process to identify complaints relating to subcontracted care providers, who were responsible for investigating those complaints. However, there was a limited system to review complaints that were received directly by subcontracted services. This meant the service could not be assured learning would be shared between providers. Managers said they would only be aware of a complaint about a subcontracted service if a hospital ward received a complaint. This would then be passed to the subcontracted ambulance provider.

The service had processes to collect feedback from people using the service. In the 12 months prior to our assessment of the service there had been 26 complaints. Managers understood the themes of complaints; the main area of complaint was around assessment eligibility. Managers told us they had a criteria that needed to be met to offer the service. However, they would always reassess a person’s eligibility if circumstances changed.

There was a clear up-to-date complaints policy. Staff understood the complaints process and viewed complaints as a learning opportunity.

People told us they either knew how to make a complaint or would be able to find out if they needed.

The evidence showed some shortfalls. The service did not always make sure people could access the care, support and treatment they needed when they needed it.

The service was free to access for people who met the criteria under the NHS Non-Emergency Patient Transport Service (NEPTS) guidelines. The service ran from 7.30am to midnight with booking requests being taken from hospital wards or people in the community. Hospital wards made booking requests by email. However, for people in the community access was only available via telephone, which meant it was not easily accessible for people without phone access or those unable to use telephones. Staff gave an example where one person in the community had been able to book through email after contacting the patient advice and liaison service (PALS) and said they would like to offer different access methods in the future.

Vehicles did not have support tools to help staff communicate with people with individual needs. This meant staff might have difficulties understanding people’s needs where verbal communication was difficult. Staff told us they had not needed additional tools to do their jobs. During our assessment, managers updated electronic equipment to include a translation app.

The service’s ward coordinator worked with ward staff to identify when people were ready to be transported.

The service transported people with a variety of different needs. Staff had access to specialist equipment to transport people safely.

The evidence showed some shortfalls. Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Managers of the service were aware of the needs of different patient groups who were eligible to use the service. However, the service did not carry out reviews into the experiences of people at risk of experiencing poorer outcomes. For example, the service did not collect specific data monitoring the experiences of people being transported for dialysis.

The service collected data to identify reasons for cancellation of transports. Managers monitored cancelled patient transport journeys and understood the main reasons for cancelled bookings.

Staff received training in equality and diversity.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service was made aware of people’s known medical wishes during the booking process. People’s wishes to not be resuscitated was recorded on the booking system. Staff knew how to find information relating to people’s wishes.

During our assessment we saw staff discussing a patient’s treatment escalation plan (TEP) with ward staff prior to transport.