Hatzola Edgware is operated by Hatzola Edgware. The organisation provides emergency and urgent care ambulance services.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 14 November 2017.

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?

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:

• Managers documented and investigated all incidents reported to them.

• We were assured that members (volunteer responders) understood what constituted an incident and how to report it.

• Vehicles and equipment were visibly clean, properly maintained and fit for purpose.

• Safeguarding training was regularly delivered and volunteers demonstrated a good understanding of safeguarding and how to raise concerns.

• Members who attended incidents and dispatchers received induction training appropriate to their roles.

• Clinical protocols were used to ensure standards met national practice guidelines.

• Members and dispatchers understood the relevant consent and decision making requirements of legislation and guidance, including the Mental Capacity Act 2005.

• Staff were caring, considerate and respectful of both patients and family members or carers.

• Hatzola Edgware followed guidance issued by the National Institute for Health and Care Excellence (NICE) and the Joint Royal Colleges Ambulance Liaison Committee (JRCALC).

• Response to call times was consistently within the provider’s target of six minutes.

• There was evidence of good multi-disciplinary team work both within the organisation and with external agencies.

• The provider actively sought feedback about the service from patients, relatives and carers.

• The provider’s vision was shared and understood by all those whom we spoke with.

• The trustees and leadership team were visible and approachable.

• Members and dispatchers felt included in decisions made by the registered manager and the board of trustees.

• Risks recorded on the risk register accurately reflected most of our findings during this inspection.

• All volunteers were proud to work for Hatzola Edgware and wanted to make a difference for patients.

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

• Medical gases were not stored securely in compliance with guidance from the British Compressed Gases Association.

• The provider did not obtain satisfactory references as evidence of appropriate conduct in current or previous employment.

• There was no formal appraisal process at the time of this inspection.

• The ‘Annual Performance & Development Review Guidance’ which related to a new appraisal system planned for January 2018 did not include dispatchers.

• There was variable compliance with National Clinical Performance Indicators for asthma and single limb fractures

• The carbon copy of the patient record form was not always handed to the healthcare provider when patients were transferred, and members did not routinely make a record on the PRF if the patient or carer declined to accept it.

Amanda Stanford

Deputy Chief Inspector of Hospitals, on behalf od the Chief Inspector of Hospitals