Grimsby Office

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 rated safe as good. We assessed 8 quality statements. There was a positive learning safety culture where events were investigated, and learning was shared to promote good practice. Staff were open and honest when things went wrong or if they identified a risk that required action. Staff protected people from abuse. Staff provided safe care and treatment. The environment was safe, free from infection and met people’s needs. Staff were trained and competent and had the right skills to meet people's needs. The service made sure shifts were covered.

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.

We were unable to speak with people using the service at the time of assessment. However, the service had a feedback mechanism which showed people had positive views about staff and the service provided.

Staff used a personal digital assistant (PDA) to report incidents and near misses. Staff were aware how to raise an incident and could show us the reporting system. Staff showed they understood what constituted an incident and told us they were encouraged to report incidents. Staff tried to resolve any issues or complaints at the time they were raised. Staff accessed information and lessons learnt about incidents on team notice boards and via email.

The service had processes and policies to report and investigate incidents and risks. The service completed a review of how they managed, reported and reviewed incidents designed to drive improvement. Leaders completed monthly reports that included incident data which showed the outcome of investigations and those investigations that were ongoing. The quality and safety team held monthly incident review meetings.

During the inspection there were no patients conveyed at the location we visited. We were unable to capture the experiences of people being cared for at the time of assessment. However, feedback provided showed people were thankful to staff for taking care of them.

Managers had established links with the commissioners who contracted their services. They worked together to ensure the transport needs of the patient were met safely by identifying and managing risks proactively and effectively. Staff felt supported to provide the right care and treatment for patients. Managers planned shift patterns in advance to enable service delivery.

The service had worked closely with the Integrated Care Board (ICB) to fulfil its contractual requirements in terms of activity reporting, patient experience and feedback and delivery and assurance against quality outcomes. The service was commissioned through the ICB and the commissioners gave positive feedback on the service they provided.

Staff used defined processes to share information and assess patient needs. Digital systems supported information sharing and daily meetings identified where further reasonable adjustments to journey plans would improve patient experience.

Staff used a personal digital assistant to report safeguarding referrals. They could demonstrate what constituted abuse and could give examples when they had raised safeguarding concerns. The service had a safeguarding policy and a designated safeguarding team.

The ICB reported that the service made timely and appropriate referrals.

The service had a safeguarding policy and procedure. There was access to a national safeguarding team. Staff were confident on how they would identify and report safeguarding incidents. There were posters in the ambulance base that signposted people to safeguarding services with contact numbers and referral details.

People who used the service were risk assessed prior to travel for additional needs. There was a criteria for transport eligibility to ensure that the service could meet patient need.

The management team managed risk across the service through auditing and environmental risk assessments. Mandatory training had been completed by all staff to reduce risk in areas such as infection control, fire safety and moving and handling.

Staff followed national guidance to care for patients during attending and conveyance to hospital. The service completed monthly operations reports for the ICB. Patients had their individual risks assessed when a journey was booked.

We were unable to speak with people using the service at the time of assessment. However, the service had a feedback mechanism which showed people had positive views about staff and the service provided.

The management team were able to describe risk assessments undertaken.

The service had enough equipment to ensure safe care for patients. This included the specialised equipment required for transporting bariatric patients and seats for children. Equipment reviewed was maintained and fit for purpose and staff had been trained how to use it properly. The location had a base room for staff, changing rooms, a kitchen, one office and a large garage to house vehicles. Vehicles checked were the oldest vehicles in the company’s fleet. There was a plan to replace them with rental vehicles. One vehicle had ripped seating, there were 2 broken locks in overhead cupboards and trip hazards noted from incorrect storage of equipment. There was also a leak in the garage roof that senior managers were unaware of. They advised that this would be remedied at the earliest opportunity.

Staff completed daily vehicle checks prior to the start of their shifts to make sure vehicles were road worthy. Seat and trolley belts were in good working order. If faults were identified, these would be flagged and managers would decide the course of action which included immediate repair or taken off road. Managers had a system for completing vehicle checks, MOTS and servicing. A third-party provider managed fleet maintenance. However, staff reported difficulties ensuring repairs happened in a timely manner. All keys to the vehicles were stored securely in locked room.

We were unable to speak with people using the service at the time of assessment. However, the service had a feedback mechanism which showed people had positive views about staff and the service provided.

Staff were supported through induction which was held centrally in Lincoln. There were enough staff to provide a good service. Managers offered overtime and additional shifts to fill staffing gaps. All staff had the relevant qualifications and training for their role. We reviewed staff files, and all the required suitability checks were undertaken.

Managers reviewed staffing and aligned it to the needs of the service. Managers supported staff and undertook appraisals. Almost all staff (94%) had received an appraisal. Due to the nature of the job, there was little opportunity for career development. Staff completed workbooks and e-learning for mandatory training. Staff were required to drive as part of their role and completed a driving assessment at induction. Managers assessed driving competence every 3 years. Staff were referred for additional training should any driving issues arise. Managers kept detailed records of driver compliance.

We were unable to speak with people using the service at the time of assessment. However, the service had a feedback mechanism which showed people had positive views about staff and the service provided.

Staff told us that it was their responsibility to check and clean the vehicles before and after use. They had the correct equipment to clean vehicles.

Vehicles were visibly clean, and stock rooms were dust free. Staff wore uniforms and name badges. The location had a garage where vehicles were stored and cleaned. On the day of assessment, a leaking garage roof meant that water had soaked some equipment in the premises. Staff could access cleaning solutions, there was a power wash, sink and Control of Substances Hazardous to Health (COSHH) products were stored safely in locked cabinets in line with COSHH regulations 2002. Wipes and hand sanitiser were available on vehicles.

Managers provided infection prevention control training and staff followed the infection prevention control policy. The service made sure staff had access to personal protective equipment, clinical antimicrobial wipes and hand sanitiser. Senior staff carried out infection prevention and control audits which identified that staff were following current relevant national guidance.

We were unable to speak with people using the service at the time of assessment. However, the service had a feedback mechanism which showed people had positive views about staff and the service provided.

Staff did not administer medicines to patients during journeys. The service had an agreement with commissioners to provide oxygen for patients who needed it during the journey with defined boundaries.

Medical gases were stored correctly in the garage area and on vehicles.

Oxygen cylinders were checked, and empty cylinders replaced using an agreement with a supplier.