ERS Medical South is operated by ERS Transition Limited. It is an independent ambulance service in Hampshire. The service primarily serves the communities in South East London and Hampshire.

The provider has been registered with CQC as ERS Transition Ltd since October 2017.

ERS Transition Limited is registered with the CQC to carry out the regulated activity of transport services, triage and medical advice provided remotely and treatment of disease, disorder or injury.

ERS Medical South primary service is transporting non-emergency patients within South East London and Hampshire.

The service has had a registered manager in post since October 2017. At the time of the inspection, a temporary registered manager was registered with the CQC.

We inspected this service using our next phase inspection methodology. We carried out a short notice announced inspection on 22 March 2019, along with an unannounced visit to the service on 29 March 2019.

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? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

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 rate

We rated the service as good overall because:

• The senior leadership team had created a culture where information was used to drive improvement and gain assurance. Through this process front line staff engaged in the change process. They shared their data with partner organisations for better decision making.
• The service had a clear vision and strategy and staff were fully aware of it. The strategy and supporting objectives and plans were stretching, challenging and innovative.
• There were systems of governance in place that had been embedded and strengthened. Staff worked with other organisations to improve patient care outcomes.
• There were effective and integrated business management systems which gave senior leaders up to date information and oversight of the service.
• There were systems in place to safeguard vulnerable adults and children. Staff could identify safeguarding concerns and knew how to report them.
• Policies and procedures were in line with national guidelines and were version controlled and within date. There was an audit programme in place to monitor compliance with policies and procedures.
• The service had good oversight of the booking process and monitored drop off and pick up times and kept patients informed about delays.
• There were systems of governance at management level to monitor performance and risk. Problems were identified and addressed quickly and openly.
• The process for shared learning from complaints was embedded. Staff told us how learning from complaints was shared.

However, we also found the following:

• Road staff at the Mitcham location were not aware on how to exchange their oxygen cylinders if it was out of date or empty. We raised it at inspection and followed it up formally with the service following our inspection. The service submitted evidence that they had informed all staff of the process for exchanging cylinders.

• The service did not have a system to make sure that local healthcare providers were informed in cases where a staff member was suspended from duty.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

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