Nest HomeCare - Windsor

Updated 22 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Our inspection site visit took place on 23 May 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit so that the management team would be available.

Inspection site visit activity started on 23 May 2018 and ended on 29 May 2018. It included visiting the office, observation of care in people’s homes and telephone calls to people who used the service. We visited the office location on 23 May 2018 to see the manager and office staff and to review care records, policies and procedures.

Our inspection was completed by two adult social care inspectors. Both inspectors visited the office, and one inspector observed care of people and completed telephone calls with people.

Our inspection was informed by evidence we already held about the service. This included notifications we had received. A notification is information about important events which the service is required to send us by law. We also checked for feedback we received from members of the public, local authorities and clinical commissioning groups (CCGs). We checked records held by Companies House and the Information Commissioner’s Office (ICO).

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Leading up to our inspection, we sent 33 surveys to gather feedback. This included people who used the service, staff, relatives and community professionals. Only two responses were received and we have not used this information as the response rate was too low.

During the home visits we spoke with two people who used the service and with three care workers. We spoke with another three people and three relatives by telephone. We interviewed three other carers at the office. We also spoke with a company director, nominated individual and manager. We observed interaction between people and staff. We reviewed three people’s care records, two personnel files and two medicines administration records.

After the inspection, we asked the manager to send us further documents and we received and reviewed this information. This evidence was included as part of our inspection.

Updated 22 June 2018

Our inspection took place on 23 May 2018 and was announced.

This is our first inspection of the service since the provider's registration.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger adults, older people, and people with physical disability, sensory impairment or dementia.

At the time of our inspection, 23 people used the service and there were 16 staff.

The provider is required to have a registered manager as part of their conditions of registration. 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. At the time of our inspection, there was no manager registered with us.

People were protected from abuse and neglect. Appropriate systems were in place to safeguard people from the risk of preventable harm. People’s care risks were appropriately assessed, mitigated and recorded. Recruitment practices and supporting documentation met the requirements set by the applicable legislation. We found appropriate numbers of staff were deployed to meet people’s needs. People’s medicines were safely managed. We made a recommendation about staff training for medicines administration.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. We made a recommendation about the required evidence for people’s enduring and lasting powers of attorney.

Staff induction, training, supervision and spot checks were satisfactory and ensured workers had the necessary knowledge and skills to effectively support people. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was collaborative working with other community healthcare professionals. People were supported to maintain a healthy lifestyle.

The service was caring. There was complimentary feedback from people who used the service and relatives. People told us they could participate in care planning and reviews and some decisions. People’s privacy and dignity was respected when care was provided to them.

Care plans were appropriately personalised and contained information of how to support people in the right way. We saw there was a complaints system in place which included the ability for people to contact any office-based staff member or the management team. We made a recommendation about compliance with the Accessible Information Standard.

People, staff and others had positive opinions about the management and leadership of the service. There was a good workplace culture and we saw the staff worked well together to ensure good care for people. Audits and checks were used to monitor the safety and quality of care. The provider met the conditions of registration and complied with other relevant legislation related to the adult social care sector. The service had built good relationships with community stakeholders to benefit people who used the service.