A community health service providing nursing care in the South of England has been praised for its “incredibly open culture” and the way it values staff by inspectors, who rated it “outstanding”.
First Community Health and Care, based in Redhill, Surrey, can now count itself among a handful of providers in England to be awarded the top inspection rating by the Care Quality Commission.
“There was a unanimous feeling that every individual member of staff counted and was valued”
The social enterprise provides services, such as district nursing and health visiting, across East Surrey and parts of West Sussex. It also runs Caterham Dene Community Hospital, employs more than 450 nurses, therapists and other health professionals and support staff.
Inspectors, who visited the organisation in March this year, identified many areas of exemplary practise including the way the service strived to meet the needs of different groups such as homeless people, Gypsy, Roma and Traveller communities and others in vulnerable circumstances.
Children’s services, in particular, were described by the CQC in its report as “exceptional”. Inspectors found a “positive incident reporting culture” at the organisation and that all staff were “actively engaged in activities to monitor and improve quality and outcomes”.
This was supported by a live performance “dashboard” that staff could access at any time, and helped easily identify areas for improvement.
Inspectors found First Community outstripped national figures for delivering harm-free care in 2015-16 and the service supported 96% of people at the end of their lives to die in the place they chose.
“I know from the positive feedback we get from patients that we provide high quality care and now to have this recognition from CQC”
They reported that patients felt involved in their care and treatment, and praised the organisation’s commitment to working in partnership with others – having forged strong links with other healthcare providers, local charities and support groups.
In addition, inspectors highlighted the service’s “care matron” joint pilot scheme with the local acute trust as an area of outstanding practice for playing an active part in reducing emergency admissions.
Other outstanding initiatives included a yellow wristband system for alerting staff to patients with additional nutritional needs.
Meanwhile, the service provided by organisation’s specialist nurses was “frequently described as a lifeline, with care widened to include support for the patient and their relatives”.
Throughout their report, published in August, inspectors were highly complimentary about the work culture, which was described as “open, trusting, caring of the employees” with a “tangible commitment to supporting staff to deliver high quality services”.
“There was a unanimous feeling that every individual member of staff counted and was valued, regardless of their role or position,” said the report. “Staff felt they could genuinely effect change and have a positive impact on the service delivered and the teams they worked in.”
“We are driven by our commitment to provide high quality health services for our communities”
Inspectors highlighted the organisation’s “Floor to Board in Five Minutes” initiative, which promises that staff can raise a concern or idea with a board member if they need to pretty much straight away.
“Staff really could speak with a member of the executive management team within five minutes of identifying a concern or idea, if they had not managed to get local advice or resolution or if they felt their comments affected the entire organisation,” said the CQC’s report.
Inspectors also flagged the organisation’s “exceptionally strong commitment to equality and diversity”. This was demonstrated by its part-time chief executive and two admin staff with learning disabilities – who were both employed on the same terms and conditions as other staff but given high levels of support to fulfil their roles.
“There was role modelling with a BME [black and minority ethnic] deputy chief nurse who had been supported to join a BME Aspiring Director of Nursing Network to enhance their development opportunities,” added the report.
As well as the overall rating, First Community’s services were rated “outstanding” for being caring, responsive and well-led and good for safety and effectiveness.
Inspectors did identify a couple of areas of poor practice and said the organisation needed to take action to ensure all nursing staff responded to call bells and requests for assistance, “in a way that meets patients’ needs”.
Community nurse provider gains coveted ‘outstanding’ rating
First Community’s chief executive Sarah Billiald said she was very proud of her team. “I know from the positive feedback we get from patients that we provide high quality care and now to have this recognition from CQC that we are providing outstanding services is a great endorsement,” she said.
“It is a reflection of the commitment and hard work of all colleagues in every department and in every location,” she added.
The organisation’s chair, Elaine Best, said the rating showed that community interest companies were a highly successful model.
“As a local social enterprise, which grew out of the NHS, we are driven by our commitment to provide high quality health services for our communities,” she said.
“I truly believe that this rating of outstanding from CQC proves that community interest companies, where services are delivered by an employee-owned organisation together with the community, delivers the best results for all,” she added.
First Community Health and Care was set up in 2011 and short-listed for a Nursing Times Award in the Improving Staff Experience category 2015.