Archived: St John Ambulance South West Region

Updated 23 April 2018

St John Ambulance became a separate legal entity and subsidiary of The Priory of England and the Islands of the Order of St John in 1999. St John Ambulance nationally provides a number of services, including first aid at events, emergency and non-emergency patient transport services and first aid training. The objective of the organisation nationally is the relief of sickness and the protection and preservation of public health. The organisation works with both volunteers and employed staff to provide services.

St John Ambulance South West Region is operated by St John Ambulance. Following an organisational review in 2016, the south west region was formed covering the West Midlands, Gloucestershire, Wilshire, Somerset, Dorset, Devon and Cornwall. The region delivers bespoke emergency services for community events but no routine patient transport services.  The headquarters are in Bridgwater, Somerset and the ambulances are located across the south west region.

The organisation has had a registered manager in post since 2011. At the time of the inspection, a new manager had recently been appointed and was registered with the CQC in April 2017.

Updated 23 April 2018

St John Ambulance South West Region is operated by St John Ambulance. St John Ambulance provides emergency and urgent care at events and a patient transport service from events to hospital.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 8 and 15 January 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the organisation understood and complied with the Mental Capacity Act 2005.

The main activity provided by this service was emergency and urgent care, with no routine patient transport activity taking place. We have therefore reported on all our findings under the single core service of emergency and urgent care.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that organisations need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• There were strong, comprehensive and embedded systems, processes and procedures to keep people safe.

• There were reliable systems to monitor and maintain standards of cleanliness and hygiene which was well documented.

• The environment was secure and suitable for safe storage of ambulances and equipment.

• The organisation had comprehensive documentation and accreditation of ISO 9001:2008 (a quality management system where an organisation demonstrates its ability to consistently provide products that meets customer and applicable statutory and regulatory requirements). Organisations used the standard to show it provides products and services that meet customer and regulatory requirements.

• The organisation had an excellent data management process with all paper patient report forms scanned and input into a secure electronic system.

• There was a genuine commitment to volunteers and value placed on the contributions they made to the organisation.

• There were comprehensive governance arrangements, which allowed the organisation to work in line with best practice and deliver high quality care. Patient care was at the centre of everything the organisation and staff did.

• Frontline staff and senior managers were passionate about providing a high quality service for patients with a continual drive to improve the delivery of care.

• There was excellent local leadership of the organisation. The registered manager had an inspiring shared purpose and was committed to the patients who used the organisation, as well as to staff.

However, we also found the following issues that the organisation needs to improve:

• The organisation must have a more secure method of posting the patient report forms to the electronic data management company.

• Ensure lessons learned from incidents are entered on the incident log.

• Level two safeguarding training should be completed by March 2018, as in the action plan.

• Terminology within the Safeguarding policy should be changed to reflect current legislation.

• Issue local safeguarding telephone numbers to staff.

• Consider a more structured approach to provide safeguarding feedback to staff.

• Improve compliance with volunteer development reviews.

• Ensure lessons learned from complaints are entered on the complaints log.

• Consider auditing daily checks of ambulances.

• Consider introducing an early warning score system for the monitoring of patient’s vital observations during transfer to hospital to detect deterioration.

Following this inspection, we told the organisation that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We issued the organisation with one requirement notice that affected emergency and urgent care services. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals 

Updated 23 April 2018

St John Ambulance provided medical events cover.

This included the regulated activity of transporting patients from event sites to local hospitals for further care and treatment.

We found St John Ambulance provided a safe and quality service under the regulated activities.