The Care Quality Commission
  • Ambulance service

St John Ambulance - South Region

Overall: Good read more about inspection ratings

16 Crowhurst Road, Brighton, East Sussex, BN1 8AP 0870 010 4950

Provided and run by:
St. John Ambulance

All Inspections

During an assessment of Emergency and urgent care

We carried out a responsive assessment on 11th July to the 17th of July 2024. Because we received information of concern about a lapse in leadership, bullying, under reporting of incidents, lack of urgent and emergency equipment, driver incidents, poor driver training and medicines management. We inspected 15 quality statements across our key questions for safe, effective and well led. We have combined the scores for these areas with scores from the last inspection. St John Ambulance provides regulated activities for urgent and emergency care. However, events work carried out by the service does not fall within the scope of this inspection. There was a good safety culture when incidents were investigated, learning was shared with staff to promote good practice. Staff provided safe care and treatment and the environment we inspected was safe and well maintained and contained adequate vehicles and equipment. The service had a small portion of paid staff and a larger volunteer crew base which included registered healthcare practitioners including paramedics, doctors and nurses who volunteered 240 practice hours a year each to support service delivery. Staff delivered good care and treatment following evidence-based practice. However, because the service had seen a change in leadership within the reporting period and had been forced to review its financial position, there were gaps in the leadership team which meant leaders were not always accessible or approachable, although recruitment was in progress for new leaders. Staff often found it hard to speak up about their concerns. Local governance process was minimal, and the service had risks. However, work streams to make improvements were still in their infancy. Some staff told us they were discouraged from speaking up or raising concerns.

During an assessment of the hospital overall

We carried out a responsive assessment on 11th July to the 17th of July 2024. Because we received information of concern about a lapse in leadership, bullying, under reporting of incidents, lack of urgent and emergency equipment, driver incidents, poor driver training and medicines management. We inspected 15 quality statements across our key questions for safe, effective and well led. We have combined the scores for these areas with scores from the last inspection. St John Ambulance provides regulated activities for urgent and emergency care. However, events work carried out by the service does not fall within the scope of this inspection. There was a good safety culture when incidents were investigated, learning was shared with staff to promote good practice. Staff provided safe care and treatment and the environment we inspected was safe and well maintained and contained adequate vehicles and equipment. The service had a small portion of paid staff and a larger volunteer crew base which included registered healthcare practitioners including paramedics, doctors and nurses who volunteered 240 practice hours a year each to support service delivery. Staff delivered good care and treatment following evidence based practice. However, because the service had seen a change in leadership within the reporting period and had been forced to review its financial position, there were gaps in the leadership team which meant leaders were not always accessible or approachable, although recruitment was in progress for new leaders. Staff often found it hard to speak up about their concerns. Local governance process was minimal, and the service had risks. However, work streams to make improvements were still in their infancy. Some staff told us they were discouraged from speaking up or raising concern

13 September 2022, 14 September 2022, 16 September 2022, 21 September 2022, 22 September 2022, 27 September 2022

During a routine inspection

We rated it as good because:

  • 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. 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. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care.
  • 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 and did not have to wait too long.
  • 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’s audits did not always ensure leaders could monitor compliance fully.
  • The service did not always correctly label sharps bins when they were in use.
  • There was a low level of compliance for staff appraisal rates.
  • Some staff carried medicines with them that they were not trained to use.
  • The service’s medicines standard operating procedure did not make clear whether two staff needed to sign controlled drugs medicine’s records in line with best practice.