LCT Ambulance Ltd provides a patient transport service.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 3 March 2017. This was announced.

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 issues that the service provider needs to improve:

• The provider did not keep records of patient journeys. This meant that they were not able to evidence the volume of work undertaken or the timeliness of their service.
• The provider had limited knowledge of the duty of candour regulation.
• The service owner had not received training and was not able to describe adjustments to facilitate the needs of unaccompanied patients with more complex needs, such as learning difficulties or those living with dementia.
• The provider did not have a risk register so he might not have identified and assessed key risks and issues.
• The service policies did not contain a revision date, did not reference national guidance and were not all relevant to the service provision.
• The provider’s website did not accurately reflect the size or nature of the services offered. This could be misleading to members of the public looking for information about the company.

However, we also found the following areas of good practice:

• The service owner had annual resuscitation training.
• The ambulance was clean, serviceable and well maintained.
• Patients’ comments about the service were all positive about the care they had experienced.

In addition the provider also reacted promptly in response to issues raised:

• The service owner had not completed any formal safeguarding or manual handling training at the time of our inspection, however undertook formal training and provided evidence of this after our inspection.
• There was no fire extinguisher on the vehicle at the time of our inspection, although an oxygen cylinder was carried. This was against health and safety regulations. However a fire extinguisher and blanket were purchased and photos were provided as evidence of these installed in the ambulance after our inspection.

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 five requirement notices that affected patient transport services. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals