The Care Quality Commission
  • Ambulance service

ION Pinewood

Overall: Requires improvement read more about inspection ratings

Pinewood Estate, Wexham Street, Stoke Poges, Slough, Berkshire, SL3 6NB (01753) 654865

Provided and run by:
ION Ambulance Care Ltd

All Inspections

During an assessment of Emergency and urgent care

Date of assessment: 06 June 2024. We inspected the service due to receiving information of concern. We assessed a small number of quality statements from the safe, caring and well-led key questions and found some areas of concern. There were concerns regarding the management of governance, including managers oversight of staff’s medicine management and how these were audited to ensure practice was monitored and safe. However, staff appeared to really care about patients, they were suitably trained and the vehicles were clean and tidy.

The scores for these areas have been combined with scores based on the key question ratings from the last inspection. Though the assessment of these quality statements indicated areas of good practice since the last inspection, our overall rating remains requires improvement.

During an assessment of Patient transport services

Date of assessment: 06 June 2024. iON Pinewood is operated by iON Ambulance Care Limited. It is an independent ambulance service located in Slough, Berkshire. iON Pinewood provides patient transport services (PTS) across the Southeast of England and urgent and emergency care services under contract with a local NHS Ambulance Trust. iON Pinewood also provides ambulances and staff to support the local NHS ambulance services with their patients’ transfer needs. It is registered with the Care Quality Commission (CQC) for the regulated activities of transport services, triage and medical advice provided remotely and the treatment of disease, disorder or injury. We inspected the service due to receiving information of concern. We assessed 12 quality statements across safe, caring and well-led key questions.

At this assessment, we found the service was performing well and meeting expectations. We rated this service as Good because the staff were trained well and treated patients with care, vehicles were clean and tidy and there was a culture of continuous learning and improvement. However, there were mixed reviews from staff regarding how they felt valued by the management team.

During an assessment of the hospital overall

iON Pinewood is operated by iON Ambulance Care Limited. It is an independent ambulance service located in Slough, Berkshire. iON Pinewood provides Patient Transport Services across the Southeast of England and Urgent and Emergency Care services under contract with a local NHS Ambulance Trust. iON Pinewood also provides ambulances and staff to support the local NHS ambulance services. It is registered with the Care Quality Commission for the regulated activities of transport services, triage and medical advice provided remotely and the treatment of disease, disorder or injury.

We inspected the Patient Transport Service and Emergency & Urgent Care due to receiving information of concern. We assessed a small number of quality statements from the safe, caring and well-led key questions and have combined the scores for these areas with scores from the last inspection.

We last inspected Patient Transport Service in 2022 where the service was rated as Good. We last inspected Emergency & Urgent Care in 2022 where the service was rated as Requires Improvement.

In our assessment we found there were concerns regarding the management of governance, including managers oversight of staff’s medicine management and how these were audited to ensure practice was monitored and safe. However, staff appeared to really care about patients, and they were suitably trained to care for them. The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly using comprehensive systems to enable reviews. Staff understood and managed risks. The facilities and equipment met the needs of people. Vehicles were clean and well-maintained, however, in one instance we did observe expired equipment. There was appropriate knowledge and use of PPE.

13/10/2021 & 24/11/2021

During a routine inspection

Our rating of this location went down. We rated it as requires improvement because:

  • 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. 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 and assessed patients’ food and drink requirements. The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care.
  • 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 took account of patients’ individual needs and made it easy for people to give feedback. People accessed the service when they needed it and did not have to wait too long for treatment.
  • It was easy for people to give feedback and raise concerns about care received.

However:

  • The service did not always use systems and processes to safely administer and store medicines.
  • The service did not always manage the risk of infection well. There was no processes to screen patients for some infectious diseases and staff did not always have access to or training on the correct level of personal protective equipment.
  • Leaders did not operate effective governance processes, throughout the service.
  • Systems for monitoring the effectiveness of care and treatment were not fully embedded.
  • The service had a mission statement for what it wanted to achieve but no coordinated strategy or vision.
  • Managers did not review competency of staff.
  • Leaders and teams did not always use systems to manage performance effectively or identify and escalate relevant risks and issues to reduce their impact.
  • Staff did not always keep detailed records of patients’ care and treatment. Records were not always clear, up to date or detailed enough to ensure good care.

31 October 2017

During a routine inspection

iON Pinewood is operated by iON Ambulance Care Ltd. The service provides a patient transport service for all age groups including from birth. Patients using the service include those with minor moving and handling needs to those requiring additional medical support during their journeys. iON is an independent ambulance service based in Slough in Berkshire. The service serves communities and patients throughout the whole of the UK. The service employed paramedics, trained ambulance technicians and ambulance care assistants.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection at short notice with announced part of the inspection on 31 October 2017.

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.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

  • Positive patient feedback relating to the service they received.

  • Staff spoke positively of the support they received from the registered manager and were happy in their role.

  • The service had a clear purpose and identification, for example, their staff uniforms and ambulances clearly displayed the provider’s name.

  • Staff received mental capacity act training and showed a working knowledge of consent issues.

  • Staffing levels were sufficient to safely meet the patients’ needs.

  • The service used its ambulance and resources effectively to meet patients’ needs.

  • Staff clearly understood their safeguarding responsibilities and the actions to take regarding suspected abuse or neglect.

  • Staff used technology effectively. This ensured they had access to safeguarding information and enabled them to take immediate action if they identified safeguarding concerns.

  • The registered manager and staff demonstrated a genuinely caring approach to the patients they supported ensuring their wellbeing at all times.

  • All incidents were reviewed by the registered manger, investigated and appropriate action taken to minimise the risk of future reoccurrence.

  • Ambulances were well maintained and a servicing programme was in place to ensure they remained available for use.

However, we also found the following issues that the service provider needs to improve:

  • The service had not always managed infection prevention and control effectively by clearly following professional guidance and the service’s own policies and procedures.

  • There was a disconnect between the company based management team and operations management team which meant there was not always as consistent well led message disseminated to staff.

  • Effective governance and risk management processes had not always been in place to ensure the continual improvement of the quality of the service provided.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and it should make other improvements though a regulation had not been breached, to help the service improve. We issued the provider with one requirement notice that affected patient transfer services. Details are at the end of the report.

Professor Ted Baker

Chief Inspector of Hospitals