First Thought Care Services

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider was clearly invested in delivering high quality and inclusive care and supporting staff to reach their potential. Staff clearly shared the passion and vision of the provider and reflected the provider’s values and work ethos. Staff and managers worked collaboratively with each other to ensure people were at the centre of the care being provided. It was clear that managers and staff worked proactively and openly with people’s relatives and professionals to ensure people received positive outcomes and good quality of life.

The provider shared their strategic vision for the future of their services across all age groups; however, we have asked the provider to conduct a thorough assessment of their services and any future developments to ensure the service adheres to the provider’s scope of registration with CQC.

At the time of our assessment a new manager had been employed and was being inducted into the service with the aim to register with CQC.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The service was run by highly capable and very passionate leaders and managers. Drawing on their own lived and working experience, the provider was dedicated to prioritising people’s safety, support, and enhance people’s quality of life through a value-driven approach to care.
Staff overwhelmingly spoke highly of the management team and the support they received from them. All staff said they were very well supported and worked well as a team in the best interests of the people they support. The provider and managers at all levels were visible and accessible with an open-door policy. The wellbeing of staff was valued and protected by the provider. Due to the demands of the role, the provider had employed a clinical psychologist to oversee and enhance the psychological well-being of staff. An award system was in place for staff and managers to nominate each other and acknowledge and appreciate staff achievements and good working practice.

Managers were supported to undertake additional management training and excel in their role. Staff at all levels were supported to develop in their career. Some staff had progressed and been promoted within the service. The dedication and commitment of the provider and staff team had been acknowledged through nominations and wins in multiple care and business awards.

A values-based recruitment approach had been implemented. Managers and staff were recruited and selected to ensure their skills, experiences, and values aligned with the provider's vision and culture. Staff retention within the service remained stable.

The provider valued staff and management feedback. Staff stated they were encouraged to make suggestions and to help shape the service to improve people’s lives and the well-being of the staff team. The provider was responsive to our feedback during the assessment and implemented and addressed our concerns immediately.
 

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

All managers and staff felt confident in sharing concerns and making suggestions to improve people’s experiences of the service and to support staff well-being. They felt their views had helped shape the service. Regular meetings at all levels and in all departments were held with the aim to discuss any issues, share good practices and for staff to voice their views. Staff said that they felt safe sharing their concerns without any fear of negative repercussions.

The provider had implemented a formal ‘speak up’ reporting system to help staff express their concerns or safeguarding issues without the need for in-person communication, which was regularly reviewed and managed through the provider's governance framework

The provider and managers understood their duty of candour responsibilities and acted with openness and transparency when things went wrong.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

Staff raised no concerns about their experiences of inequality in the workplace. All staff said they were treated fairly and that the management team were approachable if they had any personal or professional concerns. The provider stated the introduction of new internal staffing structure had increased staff retention and job satisfaction. This was confirmed by staff. The provider explained they had a diverse workforce and recruited staff locally and from overseas. One staff member said, “Judging from where I was coming from, I think they are doing extremely well. We have reviews and supervisions 1:1 where we can ask questions. They act on improvement.” They went on to explain some reasonable adjustments had been put into place for them and said, “This is only a small thing but makes a big difference.”

The provider had been awarded the status of Disability Confident Leader which reflected the provider’s commitment to create an inclusive workplace and good practices to promote disability inclusion. The provider stated, their approach started from values-based recruitment, and a continued commitment to support staff to develop and reach their potential. Staff had been supported through personal difficulties, health needs and cultural needs.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Systems were in place to ensure the quality and safety of care provided to people remained consistent. The provider had a clear staffing structure to facilitate the line management for both staff and people who used the service. Regular staff and department meetings were held to share changes, discuss issues and identify good practices. Staff had received bespoke training, and support and understood their roles and responsibilities when supporting people with complex needs. Staffing levels remained consistent and flexible to support people with their wishes and any unmet needs.

Auditing systems were used to monitor the service and quality of care being provided. However, clearer recorded links between the audits and people’s care records was needed to demonstrate whether the actions had been taken and had been effective in improving people’s lives. The provider agreed to review their policies and CQC registration to ensure they reflect the service being provided.
 

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider stated there was a strong focus on working and strengthening their partnership with health and social care professionals and people’s families to ensure the best outcome for people. The staff and managers worked well with other professionals and services to help understand and support people with complex needs and risks. The provider stated they had developed a strong management team to help support staff; however, they would engage with external professionals if additional support and advice was needed. This was confirmed by health and social care professionals.
 

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice.

There was a strong emphasis on learning from incidents by reflecting on successful practices and identifying areas for improvement with the aim to improve the outcomes for people. There was a clear strategy in place to develop the knowledge of staff teams with the aim to upskill staff with a supportive and de-escalation approach to improve people’s quality of life.

Through the provider’s own research, the provider had identified the need for people’s relatives/carers to be supported and informed about support people with complex needs. The provider explained they had identified that people’s relatives and carers needed more information and shared expertise to ensure people received consistent and high-quality support.