Eleanor Care patient transport service is based in Hanwell in West London and offers transportation for non-emergency patients. The service provides a range of patient transport vehicles including ambulances with wheelchair securing devices and ambulances with stretcher facilities. The service has 14 vehicles and 28 staff members which includes three office staff and 25 drivers.

We carried out the inspection as part of our comprehensive independent health inspection programme. The announced inspection took place on the 6 July 2016. This was followed by an unannounced inspection on the 15 July 2016. 

We saw areas of good practice including:

• There was good coordination with other providers.
• We saw staff treating and caring for patients with compassion, dignity and respect.
• Staff were passionate about their roles and dedicated to ensuring people were provided with good care.
• Staff felt valued and proud to work for the service.
• Staff felt supported by their manager.

However, there were also areas of poor practice where the service needs to make improvements:

• Incidents were documented in an incidents folder. However, we found no evidence that incidents were properly investigated and action plans put in place. Therefore, we were not assured the service was learning from incidents.
• Staff had a limited understanding of duty of candour. Duty of candour was also not embedded in the serious incident investigation process.
• Staff were not trained to the recommended level of safeguarding training, as per national guidance. Staffs understanding of safeguarding was varied.
• The safeguarding policy was out of date and did not include updated national guidance.
• There were no hand hygiene audits.
• Staff had a limited understanding of consent.
• We found limited evidence that complaints were being investigated thoroughly.
• There was no formal process in place for identifying and mitigating risk to patients.

Importantly, the service must ensure:

• Staff are appropriately trained in safeguarding adults and children. The service needs to establish systems and processes to effectively respond to any safeguarding concerns raised and prevent abuse and improper treatment of service users.
• The safeguarding policy is up to date and incorporates relevant national guidance.
• All staff receive training on duty of candour and understand their role with regards to the regulation. Duty of candour must be incorporated into the serious investigation process.

• Establish and operate effectively an accessible system for identifying, receiving, recording, handling and responding to complaints by service users . Any complaints received must be investigated and necessary and proportionate action taken. The service should ensure responses to complaints are recorded.

• That staff are following appropriate infection prevention and control practice and this is being audited to ensure compliance.

In addition, the provider should:

• Patients receiving oxygen have a documented patient care record to say how much oxygen is being given on the vehicle.

• Establish a process to identify and reduce risk to patients.

The above list is not exhaustive and the service should examine the report in detail to identify all opportunities for improvement when determining its improvement action plan.

Professor Sir Mike Richards

Chief Inspector of Hospitals