Secure 24 is an independent ambulance service operated by Definitive PSA Ltd. The service provides a patient transport service specialising in the transfer of mental health patients, including those detained under the Mental Health Act 1983.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 10 October 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?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this service was patient transport services.

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:

• Vehicles we reviewed were clean, serviceable and well maintained.
• Staff worked effectively with other providers in order to provide the transport service.
• Vehicles used by the service were bespoke and were designed with the patient and staff comfort and safety in mind.
• Patient experience forms circulated by the provider demonstrated consistently positive feedback.
• The service was provided 24 hours a day, 365 days a year.

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

• The incident reporting policy for the service lacked definition of what constituted an incident and we were not assured that all incidents and near misses were being reported. Following our inspection, the provider made amendments to their policy, including definitions and examples of what constituted an incident or near miss.
• Not all of the service’s policies such as the safeguarding or use of force policies, reflected current guidance or best practice. Following our inspection, we saw that the provider had significantly improved their policies on safeguarding and use of force, to include current guidance and best practice.
• The provider did not have a risk register for the service. Following our inspection, we saw that the provider had initiated this.

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

Amanda Stanford

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