First City Nursing Services

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• 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

For this key question we looked at 2 quality statements: capable, compassionate, and inclusive leaders and learning, improvement, and innovation. We found the Registered Manager and provider had established an innovative approach to ensuring people were supported by staff who were well supported and were listened to. We found partnership working with service users, relatives and other organisations took place frequently to support staff learning and improvement of the quality of care delivery.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We were told the Registered Manager had the relevant qualifications and experience to lead effectively and had support from the leadership team to undertake their role well. We were told the Registered Manager was aware of the risks and needs of service users and staff. They could access appropriate support from others when needed. For example, the Registered Manager told us they had worked in partnership with other professionals, who had shared their knowledge with staff to ensure the delivery of care and support with service users was current and evidence based, for example providing PEG care (enteral feeding) training to staff. Staff told us the service has a Health Assured programme for support around staff mental health and wellbeing. This had been introduced following feedback from staff. Staff spoke very positively about the support from leaders and said they were available for advice and support in the event of an emergency and were very quick to respond.

We saw processes were in place to ensure staff were supported and were provided with the training required to support service users. Team meetings and supervisions were held regularly, and the management team were available to support and advise staff when needed. We saw the provider takes care of the well-being of staff through raising awareness about mindfulness and mental well-being. We also saw the provider created a breakout room in the office for staff to take time out for self-care.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Governance, management and sustainability during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us they were involved in learning, and they were encouraged to speak up with ideas for improvement. Staff said they could make suggestions through meetings, emails, and training. Staff told us when they make requests for equipment or health professional involvement this was responded to very quickly by leaders. Staff spoke very positively about induction and training provided. Staff told us they used a range of equipment in their training, for example a first aid training manikin to train staff how to deliver first aid to a person who is choking. Staff told us people who used the service were involved with delivering training. Staff said, ‘This really impressed me and gave me the opportunity to understand what the individuals think and feel and how problems are handled.’ Staff told us about how they had used the ‘Time off to train policy’ for professional development and this had a positive impact on their role and the service. One staff member said they had completed a chiropody and foot care course and had shared their newfound knowledge with colleagues and service users and had improved awareness around foot care.

We found the provider fostered a culture of learning, improvement, and innovation. We found systems were in place to learn from incidents. Feedback from others was encouraged to make improvements to the service or mitigate the risk of a reoccurring incident. We saw the provider identified themes from incidents and included them in team meetings and staff supervisions to support staff learning from incidents. The provider demonstrated innovation to help staff to learn. For example, we saw some people who used the service were involved with training new staff. A ‘Time off to train’ policy was in place to encourage staff development and help staff to be more productive and effective at work. The provider worked with other stakeholders to support improvement and innovation. For example, working with health professionals and reviewing people’s moving and handling risks to identify if there were more effective pieces of equipment that could be used. We saw the provider had implemented an induction workbook into the staff probation process following an improvement project. We heard how the workbook has helped new staff gain knowledge and information required to carry out their roles safely and effectively.