Rapid Response Secure Care

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

There were systems to investigate incidents and safeguarding concerns. Learning was identified and changes made to the service to make improvements to the quality of care. Processes captured patient risks and enabled staff to provide safe care. Equipment was in good working order. However, recruitment checks were not always fully completed. Electronic patient records did not detail observations or key events during conveyance of patients. Cleaning equipment was not always stored safely. Substances hazardous to health were not always clearly labelled.

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.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Staff were confident in how to report incidents and concerns. They knew what types of incidents needed to be reported which included the use of restraint. Staff were aware of their responsibilities for professional duty of candour (being open and honest with patients and people when something goes wrong). They told us they had debriefs after incidents and additional training based on learning identified by the provider.

There was an effective system to report and investigate concerns. Reported incidents were investigated and actions taken to manage risks. There were processes relating to statutory duty of candour. Managers shared learning with staff on a regular basis and additional training was arranged as needed. Learning was shared with all staff during team meetings.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Staff had access to booking information that assessed patient risks. Risk assessments contained relevant patient history and current presentation. Staff completed collection assessments with partners to assess the safety of conveyance. Staff carried out dynamic risk assessments to respond to changing situations. Staff verbally informed partners of key events during conveyance. Staff were aware of when they had legal authority to convey a patient.

Staff worked well with partners to plan safe care for patients. Partners said the service worked well with them to provide care that was centred around the patient.

The provider did not always have complete patient records. Since transferring to an electronic based system to record patient information, events that happened during a patient journey were not recorded. However, the service had policies and processes to identify risks and plan safe care. The service had processes to care for deteriorating patients.

Staff understood the signs of abuse and followed processes to protect people. They knew how to raise safeguarding concerns and the action needed to protect people and felt able to do so. Staff had access to support when transporting patients and could access third party advice to raise concerns if necessary. Staff told us training helped them to identify safeguarding issues. Staff were aware of how to identify the legal authority to transport people.

Partners told us the service kept them informed of incidents and any learnings were shared.

The service had processes to protect people from abuse and improper treatment. There was a safeguarding lead trained to an appropriate level who had support from external safeguarding advisors. Staff had access to regular safeguarding training for both adults and children up to and including level 3. Records confirmed staff had completed this training and were notified when it required updating. Staff files showed enhanced disclosure and barring service (DBS) checks were completed in line with national guidelines. Safeguarding policies and procedures were up-to-date. The provider’s website allowed for people to raise safeguarding concerns to them.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Leaders worked with partners and other providers to develop risk assessments relevant to people who used the service. Staff had access to relevant information to manage risks. There were handovers with partners to support patient care. Staff monitored risks to keep people safe. Staff understood how to apply restraint safely and the importance of using de-escalation techniques to prevent the need for restraint. Staff knew what to do in emergency situations.

The service had clear risk assessments to plan patient care. Staff recorded the use of restraint and each instance was investigated with lessons shared. The service did not provide emergency care. There were exclusion criteria to ensure conveyance was done safely. Staff had basic life support training. There were processes staff followed when a patient’s condition deteriorated.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Staff felt they had adequate supplies of equipment to perform their jobs. They felt they had good systems to communicate with managers and commissioners. Staff were aware of what to do if there was a vehicle breakdown during transport. They were aware of how to report faulty equipment and completed vehicle checks.

We saw well-maintained vehicles and equipment. Restraints were visibly clean and in good working order. Substances hazardous to health were stored securely. However, substances hazardous to health were not always labelled in line with guidance. Labels did not clearly describe the substance in the bottle and associated warnings, which risked the substance being used for an unintended purpose.

The service had processes to maintain and replace equipment. They completed risk assessments for equipment to minimise risks to people. Staff completed checks on vehicles and equipment to ensure they were safe to use. Emergency equipment was available to respond to specific situations. Hazardous and clinical waste was safely managed.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure care. Approved Mental Health Professionals (AMHP) told us staff were knowledgeable and professional. One AMHP told us staff demonstrated clear communication skills during difficult circumstances, to provide care to patients.

The provider used risk assessments and guidance to allocate a safe number of staff to an ambulance crew. Staff received an induction to the service and kept up-to-date with mandatory training. Staff received regular training based on learning from reviews of the service.

The service did not always complete full employment checks. Records showed checks on staff’s full employment history did not have explanations for any gaps in employment. However, all other recruitment checks were completed correctly. Not all staff had received an appraisal, leaders told us they were looking to introduce a system of appraisals for staff who regularly worked for them. Staff were up-to-date with training that was appropriate to their roles. Training in the use of restraint was provided by an approved Restraint Reduction Network trainer. All staff involved in the use of restraint received basic life support training. There were policies and procedures to manage staff performance.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Staff had access to all the equipment and guidance to prevent the spread of infection. The booking process documented specific patient infection risks. Sufficient quantities of personal protective equipment (PPE) were available. Staff cleaned vehicles adequately after a patient was conveyed.

Staff received training in infection prevention control. Vehicles were visibly clean and stocked with PPE and cleaning equipment. However, colour coded buckets used for cleaning were stacked on top of each other which increased the risk of cross-contamination from high risk to low risk areas.

There were processes to clean vehicles to prevent the spread of infection. Staff completed a programme of deep and intermittent cleans. Staff completed infection prevention and control training.

During the assessment we were unable to observe patient care or speak with patients. Therefore, we were unable to directly capture the experiences of people being cared for. However, partners we contacted did not have any negative feedback about Rapid Response Secure Care.

Staff did not administer medication. They were responsible for recording patient’s medications during collection and drop off handovers.

Records showed the staff had checked patient’s medications when transferring care between services.

There was a process to ensure patients own medications were kept safe during conveyance. Staff recorded medications that were taken with the patient during conveyance. Medications were kept secure during conveyance. There was a medicines policy to cover staff responsibilities.