This inspection took place on 19 October 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses who are older, living with dementia or have a physical disability or sensory impairment. Not everyone using First City Nursing Services Limited Salisbury receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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. The registered manager was available throughout the inspection.

This was the agency’s first inspection since moving to their new premises. The premises enabled additional office space as well as an area for staff training.

The registered manager was responsible for First City Nursing Services Limited Salisbury and another of the organisation’s branches. They spent their time equally between the two services and were available on the telephone as required.

There was clear leadership and regular reflective practice, to look at ways to further enhance the service.

The agency was proactive and forward thinking. Value for money was considered and the agency worked with other services, to enable good outcomes for people. Emphasis was given to promoting independence and a person’s support was gradually reduced, if no longer needed.

The agency was based on strong caring values, which were adopted throughout the staff team. There was a clear focus of ensuring people received good quality care.

People’s rights to privacy, dignity and respect were promoted.

People were encouraged to make their own decisions and direct their support. There was a positive approach to risk taking, which focused on people not being restricted.

Medicines were safely managed. Staff had received training in the safe administration of medicines.

There were enough staff to support existing care packages. More staff were being recruited to enable the service to grow. Records showed new staff were safely recruited.

Staff were well supported and received a range of training to help them do their job effectively. Additional training was given to enable career progression.

People were encouraged to give their views about the service and knew how to raise a concern.