Primary Integrated Community Services Ltd (known as PICS) had their administrative base at Ash Tree Court in Nottingham and provided a range of adult community services.

During a comprehensive inspection in April 2016, the provider was in breach of Regulation 5, of the Health and Social Care Act (2014), fit and proper persons. This meant the personnel files for directors did not include the evidence required to provide assurance of their suitability to undertake the role of director.

During our focussed inspection on 1 November 2017 we reviewed four, established, director personnel files and one, new director file. We found files included the information requirements for fit and proper person and we were assured Primary Integrated Community Services Ltd were no longer in breach of this regulation.

Additionally during our focussed inspection, we reviewed progress for areas identified as ‘ should improve’, which included addressing staff knowledge of Duty of Candour and training in safeguarding. We found evidence of improvement in both of these areas.

During our inspection, we spoke with three managers, reviewed five staff (director) files, and viewed electronic evidence of meeting minutes and training records.

We do not currently have a legal duty to rate community independent health services but we highlight good practice and issues that service providers need to improve. We found:

Staff treated patients with compassion, dignity and respect. Patients were positive about their care and we saw that they were involved in their care and treatment.

Staff undertook comprehensive risk assessments of their patients and followed care plans that managed the risks. Staff understood their responsibilities to safeguard people from avoidable harm.

Patients received evidenced based care and we saw policies based on national guidance.

The organisation provided staff with appropriate training, regular supervisions and annual appraisals.

Patient’s needs and wishes were at the centre of the service. Patients were all seen at home, their needs were assessed based on the patient’s own priorities and a plan of care was devised, with the understanding, involvement and agreement of the patient. Patients had individualised plans of care, which considered personal, cultural social and religious needs.

Patients were involved in advance care planning and do not attempt cardio pulmonary resuscitation (DNACPR) decisions which were shared appropriately with other providers involved in the care.

The organisation had a clear vision, strategy and purpose, which was shared by all staff. Leadership was visible at all levels of the service. Leaders were aware of issues affecting service delivery and passionate about their staff.

Staff felt supported and there was an open, honest patient centred culture. Staff were consistently positive about working for PICS telling us they were proud of the organisation and felt valued and respected.