We found that the service maintained and respected the dignity of patients.

We saw patients' needs were assessed and that appropriate care and treatment was delivered.

There was sufficient equipment and it was safe and fit for purpose. We saw the equipment was well maintained.

There were robust systems in place for staff recruitment and thorough checks were completed for applicants.

Complaints were recorded correctly and taken seriously.

The British Red Cross (North East) is operated by the British Red Cross Society. The British Red Cross (North East) provides emergency and urgent care. We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 8 and 9 February 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.

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 service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• The service had a system in place to record and report incidents. Staff were aware of their roles and responsibilities in the reporting of incidents, near misses and concerns.
• There were systems in place to maintain cleanliness of vehicles and equipment.
• Staff maintained infection control and prevention practices through the effective use of personal protective equipment.
• Policies and procedures were in place to protect vulnerable adults and children. Staff knew how to report safeguarding concerns.
• Staff stored confidential patient records in locked cupboards.
• Staffing level and skill mix was planned and reviewed to ensure that people were safe from avoidable harm and received safe care and treatment.
• The service had effective systems in place to monitor staff’s compliance with mandatory training.
• Infection prevention and control and patient record audits were undertaken.
• All equipment had been service tested.
• Policies and guidance were based on national guidance and recommendations. Staff had access to policies and procedures on the electronic recording system.
• The service had systems in place to ensure staff competence prior to completing any roles. All staff completed a 12-week induction programme, which included examination.
• There was a system in place to demonstrate that policies had been developed, reviewed, and updated to reflect current practice.
• Systems were in place for staff to seek patient’s consent, and assess capacity to agree to treatment when required.
• We saw staff had the appropriate qualifications and experience for their role within the service.
• We observed that staff received a comprehensive induction to ensure they had appropriate training and awareness of policies and procedures.
• Staff used clean blankets to maintain patients’ privacy and dignity.
• All staff we spoke with demonstrated a consideration for the emotional wellbeing of patients and their relatives.
• Staff were understanding and sympathetic towards patient needs, adapting as required.
• Feedback forms/cards were available on all vehicles to obtain patient views.
• The service planned to meet the needs of local people, and provided a service based on risk assessments.
• Staff were experienced at dealing with patients living with a learning disability and people living with dementia.
• There was guidance available for patients to make a complaint or express their concerns.
• Patients had access to timely care and treatment.
• British Red Cross (North East) had a multi-lingual phrasebook on each ambulance as well as access to the NHS language line.
• The registered managers had the appropriate skills and experience to manage the business, and were supported by senior managers to provide a safe service.
• There was a positive culture within the service and both ambulance staff and managers displayed the service values when speaking about their work, strategy and motivations.
• Staff demonstrated learning and a positive approach to practice and care delivery.
• The service had a detailed risk register, which meant there was a robust system in place to follow up identified risks within the service.
• Vehicles were not designed to meet the needs of bariatric patient as there was no requirement to provide a bariatric service on the existing contract. Despite this, recent investment was made in upgrading two vehicles to be bariatric capable in the North East. Full training and operating procedures were written and were being delivered.
• The service obtained service user feedback through friends and family feedback forms.
• All response times were taken and collated directly by the local NHS ambulance trust as the information was not required by the Red Cross. If required the service could request audits of response times for discussion in meetings with the commissioner when reviewing performance.
• The service did collate detailed performance information relating to the number of responses, type of response and treatment of patient.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North) on behalf of the Chief Inspector of Hospitals