THE Care Quality Commission (CQC) has rated Essex Ambulance Service Limited inadequate and placed urgent conditions on its registration requiring it to assure CQC people are safe, following an inspection in November 2023. 

The Essex Ambulance Service Limited is an independent ambulance service primarily providing patient transport services, as well as first aid cover to public events. Patient transport services means transporting people who aren’t critically ill to, from, and between healthcare settings. However, the service does also perform some as-needed urgent and emergency care work for the NHS on weekends. 

The service had 32 members of staff and 15 vehicles at the time of inspection. This was the first time CQC inspected this service. 

Following this inspection, CQC has rated the service inadequate overall. It has also been rated inadequate for how safe, effective, responsive, and well-led it is. The service was not rated on how caring it is due to insufficient evidence. 

CQC has also imposed urgent conditions on the service’s registration due to concerns about people’s safety. This requires the service to provide fortnightly evidence to CQC on what they’ve done to address the concerns found. 

Hazel Roberts, CQC deputy director of operations in the East of England, said: 

“When we inspected the Essex Ambulance Service, we were deeply concerned to find leaders weren’t managing the safety and quality of people’s care well. This had led to significant shortfalls in standards being met and meant that people who found themselves using this service in emergency situations weren’t safe. 

“We found staff didn’t always have the mandatory training they needed to meet people’s needs safely. For example, not all staff were trained on how to recognise people’s health deteriorating.  

“We were very concerned by medicines management throughout the service, and inspectors found vehicles stocked with medicines that were out-of-date or unidentifiable. We also saw no evidence that staff had received training to give people medications safely, putting them at risk. 

“Leaders at the service weren’t always checking staff had the skills necessary to perform their roles and had failed to identify the issues we saw. When things went wrong, we found they hadn’t always investigated or learned from these incidents to protect people in future. 

“We’ve taken enforcement action to make sure immediate and significant improvements are made. We’ll continue to monitor the service closely, including through further inspections, to ensure people are receiving safe care.” 

Inspectors also found: 

• Equipment wasn’t always well-maintained or available for staff, including some personal protective equipment (PPE) which reduces the risk of infections. 
• People’s care records didn’t always have enough space for staff to include individual risks, meaning information important to people’s safety could be missed. 
• Staff didn’t always have the training needed to effectively support people with mental health conditions, learning disabilities, or dementia. 
• The service didn’t make sure people could access interpreters, signers, or communication aids if needed, meaning some people might not be able to communicate their needs. 
• Leaders couldn’t show evidence that they were effectively monitoring the service’s performance or making improvements to people’s care. 
• The service had enough staff to meet people’s needs when care was provided. However, leaders didn’t always ensure the service had enough staff working to carry out all the care they’d been contracted to do, as most staff were employed on zero-hour contracts and told inspectors they were offered shifts at short notice. 

However: 

• People were cared for in vehicles that were clean and well-maintained. 
• Staff worked together well, and said they felt valued and supported by leaders. 

The report will be published on CQC’s website on Thursday 1 February.