Archived: First City Nursing Services Ltd Swindon

First City Nursing Services Ltd Swindon provides a domiciliary care service and supported living service for people in and around the Swindon area. On the day of our inspection 350 people were supported by the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We were greeted warmly by staff at the service who seemed genuinely pleased to see us. The staff checked our identity before allowing us to proceed with the inspection. The atmosphere was open and friendly.

People told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People were supported by staff that were extremely knowledgeable about people’s needs and provided support with compassion and kindness. People received high quality care that was personalised and met their needs.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicines as prescribed.

There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were consistently maintained. People told us staff were rarely late and they had not experienced any missed visits. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected, this included people who were deprived of their liberty.

People told us they were confident they would be listened to and action would be taken if they raised a concern. The service sought people’s opinions through regular surveys, telephone monitoring calls and meetings and acted on the information they received. The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

The service responded to people’s changing needs and went the extra mile to enable people to achieve their potential. People and their families were involved in their care and instrumental in how their care progressed and developed.

Staff spoke extremely positively about the support they received from the registered manager. Staff supervisions and meetings were scheduled as were annual appraisals. Staff told us the registered manager was very approachable and supportive and that there was a very good level of communication and trust within the service.

The provider had created a charity that supported people in the wider community. People using the service also received support from the charity and volunteers befriended people which enhanced their wellbeing and reduced the risk of social isolation. Many of the staff were also volunteers.

People told us the service was very friendly, extremely responsive and very well managed. People knew the managers and staff and spoke extremely positively about them. The provider’s ‘No/How’ pledge underpinned the services attitude of positive responses to issues, concerns or requests.

The registered manager led by example and motivated staff. Communication within the service was very good with a clear management structure to manage this large service.

All people introduced to the service were visited by senior staff who completed an initial care needs assessments with them, and their family members if appropriate. Information provided by other relevant health professionals was also considered. The initial care needs assessment followed the principles as stated by the provider in their service user guide, that 'it is particularly important to find out the service user's wishes and feelings and take them into account, to provide the service user with full information and suitable choices, and to enable and encourage the service user to make decisions about their own care'.

We received positive comments from families of people using the service. One relative said "we set a target, and now take it for granted that improvements will continue to be made"

We spoke with staff who confirmed how they were well supported by the management team, and that there was always a person to contact if they had any concerns. A member of staff described the service as a "great place to work".