1 and 14 May 2019
During a routine inspection
Thames Ambulance Service Lincoln Office and Grantham location is operated by Thames Ambulance Service Limited. The service provides a non-emergency patient transport service from several sites throughout England. Thames ambulance Service Ltd had 16 ambulance stations throughout the UK from which patients transport services were delivered. This inspection report details our findings at the Lincoln Office and Grantham location.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 1 May 2019 along with an unannounced visit to the service on 14 May 2019.
We previously carried out an announced comprehensive inspection as part of Thames Ambulance Service Limited on 23 October 2018. During our inspection, there were several safety concerns identified, primarily regarding the safe transport of patients with mental health needs, transport of patients with bariatric needs and transport of children aged under 12 years. Because of this, we issued the provider with a warning notice over their non-compliance of Regulations 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also imposed four further conditions on their registration.
Prior to this, we carried out focussed inspection on the 15 May 2018 to follow up a warning notice we had issued to the provider in October 2017 over a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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.
Our rating of this service improved. We rated it as Requires improvement overall.
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The service did not have enough staff in all areas.
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The service managed safety incidents but did not always share the lessons well.
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Managers did not monitor the effectiveness of the service to make improvements to meet KPI targets.
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People had to wait for the service which was sometimes delayed, appointment times were not always met.
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Processes to improve staff and patient engagement were in their infancy.
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Leaders did not always use information systems and information to improve services.
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Staff did not understand the service’s vision and values, and how to apply them in their work.
However, we also found:
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Staff training had improved, and staff understood how to protect patients from abuse.
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Staff provided care and treatment in line with national guidance.
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Staff had made improvements to work together for the benefit of patients.
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Key services were available seven days a week.
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Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions.
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Staff provided emotional support to patients, families and carers.
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The service had made some improvements to plan care to meet the needs of local people and their individual needs.
We rated the service as Requires improvement overall.
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, to help the service improve. We also issued the provider with one requirement notice that affected patient transport services. Details are at the end of the report.