PSS Birmingham

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question as good. At this assessment, the rating remained good. This meant people were supported and treated with dignity and respect. However, staff did not feel their wellbeing was supported.

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 did not observe any patient journeys during this assessment and were unable to speak to patients. The service asked patients to complete satisfaction surveys with low results. They had 16 responses in between August and November 2024. Results were mixed. Most were positive with only 4 out of the 16 containing a negative response. There were no further comments added where negative scores were allocated. Positive comments included “I was treated with dignity and upmost respect”, “very good journey, initially I felt angry, but now I am happy” and, “good group of people, really nice.”

There was mostly a culture of kindness and respect between the staff. Most staff felt supported by their colleagues, particularly the ambulance staff. They felt their colleagues were kind and respectful towards the patients. One staff told us the ‘staff are kind and caring to the patients’. Staff understood and respected the personal, cultural, social, and religious needs of patients and how they may relate to care needs. We spoke with stakeholders who told us the staff treated their patients well. One told us “Prometheus staff are very professional, they have experience working with our mental health patients and have a rapport with most of our patients that they have transported before.”

We attended a transfer which did not take place and did not see any patient interaction. However, we observed the crew for this transfer providing a caring attitude on arrival to the ward and to all staff they were involved with.

The service had a system for gaining feedback from customers in performance and quality but feedback gained was minimal. They were looking to move to digital feedback to make it easier for patients to complete. Feedback from stakeholders using this system included “really great working with you, your service delivery is outstanding. Very supporting team, dignity for our patients is always assured, thank you.”

People’s individual needs and preferences were understood and reflected in their care. People’s communication needs were met to enable them to engage in their care, to maximise their experience. For example, staff asked patients their music choice for the journey. One staff gave us an example where the patient was more relaxed if they coloured, and they facilitated this on the journey.

We did not observe any patient care as part of this assessment.

The service did a paper patient questionnaire which enabled them to gain feedback from patients. They also logged complaints and compliments received. They were introducing tablets onto the ambulances for online feedback to make it easier for patients to fill and to simplify data analysis and collection.

We did not observe any patient journeys during this assessment and were unable to speak to patients.

Patients were sectioned under the MHA and therefore did not have choice over their transfer. However, the ambulance allowed for as much independence as possible and they did not restrain patients unless they had to. Staff told us they gave patients as much independence as was safely possible.

There were processes to ensure patients were sectioned appropriately which meant they did not have control but the staff ensured they were conveyed safely.

The service kept a compliment log and in October 2024 received a compliment from a provider saying “Prior to meeting the patient the whole team were interested to get a handover of the best ways in which to interact with them, what their triggers were, likes, dislikes and management plans we had used with them. When they met the patient, they were extremely compassionate and respectful, they tried their best to encourage them to leave the building willingly. Offering all options including picking who drove, music they would play, whom they would walk with etc. It was very nice to see.”

Feedback data was gathered from stakeholders, compliments, questionnaire comments and complaints. Results were shared with the staff by email or within team meetings. The service sought feedback from patients through the patient questionnaires and feedback from stakeholders. Results were discussed at clinical governance meetings. However, staff told us they did not receive the feedback from these.

We did not observe any care being delivered during the assessment.

The wellbeing needs of staff was not fully recognised or fully met. Morale was low for most ambulance staff we spoke with. They did not feel the managers looked after their wellbeing. There had been a recent transformation project which had resulted in staff’s pay being reduced significantly. This had affected staff wellbeing and morale at work. Staff we spoke with as a result, did not trust the management and whilst they were offered support, they did not feel listened to or that the managers cared. Managers were aware of how staff felt and had completed a wellbeing survey in October 2024 which had low scores, which they were expecting. Managers told us they wanted to build bridges with the staff and improve the strained relationships following the transformation project and impact of the changes that had been made. Staff were not always able to provide feedback, or if they did, they did not feel their suggestions about ways to improve the service or staff experiences were always heard or acted on very quickly. Managers had team meetings to feedback to staff and hear their suggestions for improvements, but staff did not feel they could speak up, or they were listened to. Feedback was also disseminated via an application which sent notifications to the staff. We saw mostly high numbers of views on information disseminated via the application but staff we spoke to did not seem to be fully engaged with this application. The service offered an employee assistance programme which gave staff access to support such as counselling. The managers had arranged mental health first aid training in January and February 2025. They were also creating a staff council where staff nominated their own representatives to for a council which would become part of the governance structure and mean the staff views are fully represented.

Staff completed a wellbeing survey every 6 months. Results from May to October 2024 showed a big decline in the satisfaction of the staff. For example, when staff were asked if they felt the organisation cared about their mental wellbeing, this declined from 45% in May to 22% in October 2024. Comments for suggestions about how they could better support wellbeing included “better and more consistent communication with management” and “the organisation doesn’t care about our well-being and mental state.” Staff gave us similar feedback when we completed the assessment in November 2024. Staff morale was low, they felt managers did not listen to them, they did not receive feedback, and felt they were not well supported. Managers told us staff were impacted hugely by the transformation project and they were supporting them, but it was evident that it was not being felt by the staff. In October they launched their staff newsletter to foster a culture of inclusivity, engagement and improve wellbeing. They wanted to highlight achievements, share updates, and promote initiatives that support wellbeing and company values. They created an action plan following the October 2024 survey with actions of how they wanted to improve how staff felt at work. This included creating a staff counsel to ensure they had the staff voice. They had started to produce “above and beyond” posters to encourage staff to share news and recognise colleagues who excel. They had a mindful colouring station in the break area in the office for staff to use if they needed to step away from their desk. Managers promoted and celebrated world mental health day. There were ‘tea and talk’ sessions in October to encourage mindfulness which raised money for Mental Health Foundation; this was highlighted in November 2024 newsletter. The managers had also negotiated a gym membership with a reduced fee at the gym next to the office to encourage physical and mental health wellbeing.