Archived: St John Ambulance South East Region

Updated 17 February 2020

St John Ambulance South East is operated by St John Ambulance. The service was first registered in 2012. It is an independent ambulance service and covers the South East of England. St John Ambulance South East region is part of St John Ambulance, which is a national charity providing first aid and other ambulance services. 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 primarily provides first aid across the country and services include emergency and urgent care, non-emergency patient transport, and first aid and ambulance provision for events.

St John Ambulance South East region provides first aid cover for events and patient transport services to take patients to and from hospital on behalf of a local NHS ambulance trust. The provision of first aid at events is not in the Care Quality Commissions (CQC) scope of regulation. However, if a patient needs to be transferred to another provider from an event for continuing care needs then the treatment and care given to the patient during transport is subject to CQC regulation. The CQC also has responsibility to regulate patient transport services.

The provider is contracted to an NHS trust to provide blue light transfer of neonatal intensive care and paediatric intensive care transfers, and maternity transfers from a midwifery led unit to an NHS hospital.

The service is staffed by trained paramedics, ambulance technicians and ambulance care assistants.

St John Ambulance South East is registered to provide the following regulated activities:

• Transport services, triage and medical advice provided remotely.

• Treatment of disease, disorder or injury.

The service has had a registered manager for both regulated activities in post since March 2012 with the current registered manager being in post from November 2016.

The management strategy and leadership model of the service is the same for both the emergency and urgent care service and the patient transport service. The same staff deliver both the emergency and urgent care service and the patient transport service. Where our findings on emergency and urgent care service, for example, management arrangements, also apply to the patient transport service we have not repeated the information but cross-referred to the emergency and urgent care service.

We inspected this service in 2016 but at that time did not have the power to rate the service provided.

At the last inspection the service was given the following actions:

We told the provider it must:

• Review the safeguarding training programme to ensure it meets all national recommendations and staff have completed the correct level of safeguarding children training for their role.

• Ensure policy and procedures are followed when vehicle defects are reported, to keep patients and staff safe.

And the provider should:

• Provide a target compliance rate for mandatory training and appraisals and monitor compliance against this target.

• Ensure all volunteers have completed their mandatory training and received an appraisal.

• Provide a review process for staff working for the service on a casual basis.

• Review the provision of equipment for the safe transportation and care of children.

• Ensure all medicines are stored in accordance with regional policies and procedures.

• Ensure the multi-lingual phrase book is stored on all vehicles at all times to support patients to receive safe care and treatment.

• Consider providing a communication aid to support patients who are unable to communicate verbally

Updated 17 February 2020

St John Ambulance South East is operated by St John Ambulance. St John Ambulance South East region provides emergency and urgent care services and a patient transport service. The South East region is part of the London and South region within St John Ambulance which covers 9 counties. This inspection and report covered the South East region only.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 10 to 11 December 2019.

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 provider understood and complied with the Mental Capacity Act 2005.

The main service provided was emergency and urgent services. Where our findings on emergency and urgent services – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the emergency and urgent services core service.

We rated it as Good overall.

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.

• Staff provided good care and treatment, gave patients enough to drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key emergency services were available seven days a week.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.

• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.

• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

  However:

• The service did not monitor the temperature storage of medicines which would not assure them of the efficacy of the medicines.

• The service did not provide training for all staff on the use of child restraints.

• Not all policies had been recently reviewed and therefore the provider could not be assured staff were using up to date policies.

• Not all ambulances contained information for patients on how to make a complaint or compliment.

  Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief inspector of Hospitals (London and South East) on behalf of the Chief Inspector of Hospitals.

Updated 17 February 2020

Patient transport services were a small proportion of activity. The main service was emergency and urgent services. Where arrangements were the same, we have reported findings in the emergency and urgent services section.

Some patient transport was purchased privately however, when we inspected, the service had recently (December 2019) been assisting NHS Trusts with the high level of discharges due to the time of year. At the time of the inspection there had been 17 contracted journeys completed and from January 2019 to the date of the inspection there had been 261 journeys.

Updated 17 February 2020

The management strategy and leadership model of the service is the same for both the emergency and urgent care service and the patient transport service. Some staff deliver both the emergency and urgent care service and the patient transport service. The service managed 200 vehicles from the Guildford base; 95 of these were operational ambulance vehicles meaning they could be used for urgent and emergency or patient transport services. Where our findings on emergency and urgent care service, for example, management arrangements, also apply to the patient transport service we have not repeated the information but cross-referred to the emergency and urgent care service.

We rated this service as good overall because it was safe, effective, caring, responsive and well-led.