Nest Healthcare

Ratings

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

We carried out this assessment to follow up on the breaches identified at the last inspection. During our last inspection, we rated the provider as inadequate. Because of the serious concerns we had about client’s safety whilst undergoing detoxification for alcohol and drug use, we served a Notice of Decision. We told the provider they must not admit any new client's or re-admit a previous client to Nest Healthcare for alcohol or drug detoxification without the prior written agreement of the Care Quality Commission. During this inspection we noted improvements in all areas of the service. However, as the provider had only had one admission since our last inspection, we could not be assured that all systems, processes, and improvements had been embedded, so the decision was made not to remove the Notice of Decision at this time. We inspected 30 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with scores from the last inspection to give the rating. During this inspection, we found breaches in the following areas: The service must ensure it has individualised early or unexpected exit from treatment forms located within client’s files (Regulation 12) The service must ensure that governance systems and process including audits are in place. (Reg 17) The service must ensure it has a personalised ligature risk assessment and ligature risk management plan in place. (Reg 17) The service must ensure staff have access to regular supervision, appraisal and team meetings in line with the providers policy. (Reg 18) The provider must ensure that duty of candour is considered, and the duty of candour policy is followed when something has gone wrong. (Regulation 20)