Archived: St John Ambulance West Midlands Region

Updated 11 February 2020

St John Ambulance West Midlands Region is operated by St John Ambulance. The service opened in 1999. The service opened with one manager and one ambulance crew. It is an independent ambulance service in West Midlands. The service primarily serves the communities of the West Midlands.

The service has had a registered manager in post since November 2016.

The service was first registered on 21 October 2012. St John Ambulance West Midlands Region is part of St John Ambulance, which is a national charity providing first aid and other ambulance services. St John Ambulance became a separate legal entity and subsidiary of The Priory of England and the Islands of the Order of St John in 1999. St John Ambulance primarily provides first aid across the country and services include emergency and urgent care, non-emergency patient transport, and first aid and ambulance provision for events. St John Ambulance West Midlands Region provide first aid cover for events and patient transport services (PTS) to take patients to and from hospital on behalf of a local NHS ambulance trust. The provision of first aid at events is not in the Care Quality Commissions (CQC) scope of regulation. Although if a patient needs to be transferred to another provider from an event for continuing care needs then the treatment and care given to the patient during transport is subject to CQC regulation. The Care Quality Commission also has responsibility to regulate patient transport services. The service is staffed by a range of people including trained paramedics, ambulance technicians and ambulance care assistants.

The aim of the organisation is to offer first aid to those who need it and to ensure communities are provided with first aid trained staff. St John Ambulance West Midlands Region is registered to provide the following regulated activities:

• Transport services, triage and medical advice provided remotely.

• Treatment of disease, disorder or injury.

The service has two registered managers one for each of the core services.

The current registered manager for transport services, triage and medical advice provided remotely has been in post since October 2019.

The current registered manager for treatment of disease, disorder or injury has been in post since 2018.

The management strategy and leadership model of the service is the same for both the emergency and urgent care service and the patient transport service although each have their own dedicated manager. Some staff deliver both the emergency and urgent care service and the patient transport service. Where our findings on emergency and urgent care service, for example, management arrangements, also apply to the patient transport service we have not repeated the information but cross-referred to the emergency and urgent care services service core service.

We inspected this service in 2017 but at that time did not have the power to rate the service provided.

At the last inspection the service was given the following actions:

We told the provider they should:

• Review the safeguarding awareness training programme to ensure that it meets all national recommendations as set out within the intercollegiate document.

• Ensure that audit results reported through the national yearly audit programme are used at a regional level to support and secure local service improvements.

Updated 11 February 2020

St John Ambulance, West Midlands Region is operated by St John Ambulance. This inspection and report covered the West Midlands region only. The main service provided by this ambulance service is emergency and urgent care. The service also provides a patient transport service for the local NHS trust. Where our findings on emergency and urgent care, for example, management arrangements, also apply to other services, we do not repeat the information but cross-refer to the emergency and urgent care section.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 21 and 22 November 2019.

During our inspection we rated the service using our five key lines of enquiry. We looked at if the service was safe, effective, caring, responsive and well led. We were unable to rate caring for the emergency and urgent care service as we did not see any regulated activities being carried out.

The St John Ambulance service has both paid staff and volunteers working within the service. Throughout the report when staff are referred to it means both staff and volunteers.

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.

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.

We rated it as Good overall.

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.

• Staff provided good care and treatment, gave patients enough to drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.

• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.
• 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.

Heidi Smoult

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

Updated 11 February 2020

Patient transport services were a small proportion of activity. The main service was urgent and emergency services. Where arrangements were the same, we have reported findings in the urgent and emergency services section.

The patient transport service was contracted by local NHS trusts, including an acute trust and a hospice. Between November 2018 and November 2019, there had been 17,798 patient transport journeys.

Updated 11 February 2020

St John Ambulance is a national charity that is split into four regions. This service sits in the West Midlands region and provides first aid cover for events and transfer from site to another provider. Urgent and emergency services were the main activity. The service carried out 203 emergency and urgent service patient journeys from November 2018 to November 2019.

Where arrangements were the same across both urgent and emergency services and patient transport services, we have reported findings in the urgent and emergency services section.

Staffing, equipment, vehicles and most processes were the same for both the urgent and emergency services and the patient transport t services.

We have rated this service good overall.