Nest Healthcare

On this page

• 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

We rated well led as requires improvement. We assessed seven quality statements. The provider had developed a system of governance and risk management. However, due to low referrals this had not yet been embedded. Leaders had focussed on training and development of staff to work in a substance misuse setting and staff felt supported by management. Leaders had begun to gain skills and knowledge to perform their roles. However, due to low referrals, they still lacked experience.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers told us the vision of Nest Healthcare was to support people emotionally and physically and offer them a retreat so they could lead a life free from drugs. The provider was unable to describe how they demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service. However, the manager was able to describe the services focus on learning and improvement following its last inspection. Staff understood equality, diversity, and human rights, and they prioritise safe, high-quality, compassionate care. Overall, 100% of staff had completed diversity, equality, and inclusion training.

The provider had an induction programme in place, which included organisational culture, and the providers strategy and vision. Staff confirmed they had completed the induction and said it was useful to support them in carrying out their roles.

Staff told us that managers were visible within the service, that they were competent and available for support. Staff said they had no experiences of poor culture within the service.

Key information, critical to the running of the service was not available at the time of inspection and evidence that was submitted as part of the onsite inspection was often out of date or not submitted in a timely manner. Leaders had focussed on improving their skills and knowledge of managing a substance misuse rehabilitation service since our last inspection. However, due to the low number of admissions since our last inspection, any learning had not yet been put into practise.

Leaders told us they had a whistleblowing procedure in place that staff were aware of. However, no staff had used the whistleblowing process. Leaders said they had an open and honest culture within the service.

The provider had a whistleblowing process in place that staff were aware of. The service did not have a freedom to speak up guardian in place.

Managers told us there had been no incidents of bullying or harassment amongst staff. Staff we spoke with told us that since the last CQC inspection and low admission numbers they had been offered other roles within the organisation and had stayed as bank staff for Nest Healthcare.

At the time of inspection, leaders had not ensured there were effective and proactive ways to engage with and involve staff. However, this was due to there being only one admission within the last 6 months.

Managers described how they had begun to develop effective governance arrangements. However, due to the low numbers of referrals and admissions since the last inspection these had not yet been fully embedded or developed. This included an audit schedule, and team meetings to share information. Managers told us that due to the lack of admissions, staff had not required regular supervision or appraisal as they had not been based at the service.

The service had developed a new ligature risk assessment and ligature risk management plan since our last inspection. However, managers had used a generic ligature risk assessment template and not amended parts of the ligature risk assessment to suit the building or grounds. The ligature risk assessment did not include radiator covers as part of the assessment. The provider had submitted notifications to the local authority and CQC as required.

Managers told us how they had begun working in partnership with key organisations to support care provision, service development and joined-up care. This would develop more as the service was able to accept more referrals. Managers told us how they were open and transparent with external stakeholders and agencies following their last CQC inspection.

Leaders had engaged with communities and partners to gain learning that resulted in continuous improvements to the service.

Staff told us they were unsure if the provider collected or analysed data about outcomes and performance or engaged in local and national quality improvement activities. Managers told us how they had a quality improvement plan in place and had received support externally to improve services. However, due to low levels of admissions, the quality improvement plan was ongoing and developments within the service could not be verified until the service had experience of more admissions.

The provider had a whistleblowing process in place that staff were aware of. The service did not have a freedom to speak up guardian in place.