HTG South West - Dorset

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider demonstrated a good level of safety. A robust learning culture was evident, with clear incident reporting, thorough investigations, and implemented improvements. While booking challenges existed, staff proactively mitigated risks. Safeguarding pathways and procedures were in place and staff knew how to report safeguarding concerns. Vehicles were well-maintained d equipped, and infection control practices were followed. Staffing levels were reported as adequate, with effective recruitment and training. Overall, the provider demonstrated a commitment to patient and staff safety.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We have been unable to collect any evidence for this evidence category.

Staff knew how to report incidents and where to find relevant policies and procedures. While staff told us they did not always get consistent feedback on serious incident investigations, we saw information was shared at staff meetings. Therefore, staff feedback, although not provided via a dedicated platform, was obtained in other ways.

We looked at incident reports from February to July 2024, along with staff policies and reporting forms. We found investigations were clear and thorough, and patients and families received feedback. These investigations included important details like how much harm was done, what happened, where and when it happened, who else was told, and what was learned. This approach followed national guidelines for independent healthcare services. This process helped share lessons learned (while keeping names private) to improve safety and prevent similar incidents. We also found evidence of implemented change because of this, demonstrating a positive learning culture. The service had a complaints policy, and we saw examples of complaints, how they were investigated, and what was learned from them. Regular staff meetings facilitated information sharing, as reflected in meeting minutes, and the service consistently applied the duty of candour when addressing complaints, fostering transparency and accountability.

We accompanied an ambulance crew to collect a patient from the hospital and talked to them about their experience. The patient said they felt safe and respected. They told us the crew communicated well and made sure they were comfortable, even over bumps. The patient informed us they were happy with the pickup time and when they got home, the crew worked with the Occupational Therapy team to help them into a chair. Although the wheelchair provided needed some maintenance due to wear and tear, the patient’s overall experience was good. This was further supported by patient surveys, where 86% of respondents in the Friends and Family test rated the service as ‘very good’, particularly commending staff courtesy and care.

Staff and managers described challenges with patient transport, primarily due to incorrect or missing booking information. We were told this frequently led to delays and/or cancellations. In response to this, staff incorporated on-the-spot risk assessments. For instance, if a booking form lacked patient mobility information, staff would directly assess the patient’s needs and ensure they had the correct equipment to accommodate this. Reporting these incidents led to improvements, like mandatory patient weight fields on booking forms, demonstrating proactive risk management and collaboration with other services. While some staff raised concerns about single-crew operations and limited equipment availability, the service tried to improve efficiency and reduce wait times by optimising ambulance routes and pairing patients. These measures aimed to improve efficiency and reduce waiting times for service users.

We have been unable to collect any evidence for this evidence category.

The service had up-to-date policies that gave staff the procedures they needed to work safely. For example, the lone-working policy limited solo shifts after certain hours. This meant the service was committed to staff and patient safety by setting clear guidelines. We also reviewed 10 vehicle checklists to ensure they met the service’s safety standards for regular maintenance, ensuring crews received safe vehicles. This meant the public could have increased confidence that vehicles used were regularly checked and maintained, and indicated there was a system in place to promote vehicle safety. The dialysis coordinator also played a key role in making sure dialysis patients got to their appointments on time, prioritising their needs and working with ambulance crews to avoid delays. This dedicated approach was a positive initiative.

Staff told us they could easily contact safeguarding leads for support and guidance, and they understood safeguarding escalation procedures. We were told the team responded quickly to concerns and a safeguarding policy was in place.

We have been unable to collect any evidence for this evidence category.

The safeguarding team comprised of 6 trained individuals which meant there was a dedicated resource for handling safeguarding concerns. All new Ambulance Care Assistants (ACA) had to complete level 2 safeguarding for children and adults. While an online system tracked training compliance and sent reminders, some transferred staff could not evidence their compliance. However, this issue was discussed with managers during the assessment and an ongoing plan was in place to address this. We have since received evidence provided by the service which has demonstrated improvements in compliance with safeguarding training for all staff. Real-time tracking through personal devices allowed managers to monitor staff locations, especially during long or solo shifts, improving safety for both staff and patients.

We have been unable to collect any evidence for this evidence category.

We have been unable to collect any evidence for this evidence category.

The provider demonstrated inclusivity, offering translation services to help communicate effectively with people who had diverse needs. This helped to ensure patients could understand and be involved in their care, and staff could share information accurately. Similarly, the service further promoted inclusivity by the use of non-discrimination policies and procedures for staff to follow.

We have been unable to collect any evidence for this evidence category.

Staff had some concerns about safely transferring bedbound patients upstairs. Although using a scoop stretcher for these transfers follows guidelines, some staff were not comfortable with it, as scoops are generally meant for short lifts, not carrying patients for longer distances. Managers addressed this by reminding staff during training about the proper way to use scoops and their limitations. This was to ensure staff felt confident and comfortable using equipment safely and effectively. Staff also confirmed they followed health and safety rules, including using Personal Protective Equipment (PPE).

The service vehicles were equipped with necessary patient transport equipment, such as wheelchairs, ramps and oxygen. Oxygen cannisters were secured both at the base and within vehicles, adhering to national guidance to prevent movement during transit and to ensure a stable and safe environment for patients. Ambulances were clean, there were no visible signs of damage or neglect, and all essential systems and components appeared to be functioning correctly.

Regular health and safety audits and vehicle inspections helped to ensure a safe working environment. As a result of these audits, we saw vehicle safety problems, like missing PPE or cleanliness issues, but these were escalated and dealt with quickly. These checks were conducted monthly and on an ad hoc basis and this included all vehicles and the base itself, demonstrating a focus on safety and quality standards. Staff also had easy access to paper copies of policies and procedures in their vehicles, giving them what they needed to handle different patient care situations, including forms for end-of-life care, incident reporting, and translation services. Vehicle keys were kept locked up, and staff signed them in and out, which helped keep vehicles secure, made staff accountable, and allowed for vehicle tracking.

We have been unable to collect any evidence for this evidence category.

The service appointed a new assistant station manager to support staff development and leadership skills, and a practice educator to facilitate staff learning. We discussed concerns about training gaps for transferred staff, and the practice educator explained they received refresher training while awaiting full training sessions. They confirmed they were working closely with staff, using sign-off sheets to track competency. Staff reported adequate staffing levels. While staff spoke positively about management, they noted the significant workload at this level.

The service had effective recruitment practices, with complete and up-to-date staff files, including Disclosure and Barring Service checks and references. Our review of 5 recruitment files confirmed they met all required standards. To cover staffing shortages, the service sometimes used bank and agency staff. Rota's were planned to meet patient demand, and new staff received a thorough induction covering the service's values, code of conduct, professional development, and equality, diversity, and inclusion, among other topics. New staff also got an overview of Human Resources (HR) procedures and workplace expectations. Rota planning was effective, with staffing levels matched to patient demand, and leaders proactively arranged for extra bank and agency staff when needed. To facilitate training and collaboration, a classroom off-site was established, and a clinical tutor was always available for staff support and guidance. The clinical tutor was responsible for training ACA’s and oversaw the First Response Emergency Care Level 3 staff. Furthermore, a partnership with a local trust’s renal unit brought in-patient and nurse expertise to enrich HTG South-West Dorset’s induction process, providing real-life insights.

We have been unable to collect any evidence for this evidence category.

Staff told us they cleaned vehicles in-between patient use and at the end of each shift, in line with their infection control policies. Leaders told us vehicle deep cleans occurred every 6 weeks, with additional cleans as needed. For example, a vehicle was taken out of service due to a flea infestation while awaiting to be deep cleaned by an external company.

Vehicles were observed to be clean and well-maintained. The service used a national colour coding system for cleaning equipment. The correct mops and buckets were used according to this scheme which helped to prevent cross-contamination. The base appeared visibly clean and tidy.

Records showed deep cleaning followed infection control policies. A cleaner handled daily base housekeeping, and staff cleaned vehicles. Spot checks also monitored infection control practices, and our review of these records found no issues. The service had a compliant system for managing clinical waste, using appropriately marked bins.

We have been unable to collect any evidence for this evidence category.

We have been unable to collect any evidence for this evidence category.

Oxygen cylinders at the base were stored in compliance with the Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations. Cylinders were secured to prevent falling over, and kept locked when not in use. They were stored in an open, well-ventilated area, away from direct sunlight and high temperatures. Additionally, vehicles carrying oxygen cylinders were equipped with appropriate fire extinguishers, further demonstrating adherence to safety protocols.

Medication administration generally fell outside the scope of practice for patient transport services. However, clear guidelines and appropriately trained staff were in place for the permissible administration of oxygen, when required.