First Care Ambulance is operated by First Care Ambulance Limited and provides patient transport services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 17 and 18 April 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 provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this service was patient transport.

Services we do not rate

We regulate independent ambulance services but at the time of the inspection we did not have a legal duty to rate them. We highlight good practice and issues that service providers 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.
• The environment was secure and suitable for safe storage of ambulances and equipment.
• Patient care was at the centre of everything the organisation and staff did.
• Patient’s individual needs and preferences were central to the planning and delivery of the service.
• There was a commitment from frontline staff and senior managers to provide a high-quality service for patients with a continual drive to improve the delivery of care.
• The organisation had a flexible and responsive approach and had developed a positive partnership with commissioners.
• The registered manager and the management team were committed to the patients who used the service, as well as to staff.

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

• The named professional responsible for safeguarding was not trained to level four for safeguarding in line with the recommendations in the intercollegiate document. ‘Safeguarding children and young people: roles and competencies for health care staff’ (2014).
• Medicines were not administered and supplied with the correct legal authorisation of a patient group direction. Paramedics required a patient group direction to administer any prescription only medicine that was not on the exemption list.

Following this inspection, we told the provider 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 also issued the provider with two requirement notices that affected the service. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (South), on behalf of the Chief Inspector of Hospitals