Together Nest Lane

Updated 29 January 2019

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.

This announced, comprehensive inspection took place on 3 January 2019. We gave the service 24 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. We also wanted people living at the home to be aware of our inspection. This gave people the opportunity to discuss any worries with staff about the inspection and for them to be supported with these. We made one telephone call to staff on the 4 January 2019.

The inspection team consisted of one inspector.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. We considered the information provided within the PIR in making our inspection judgements.

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

We reviewed other information we held about the service. This included notifications regarding important events which the provider must tell us about. Notifications are changes, events or incidents the provider is legally required to tell us about within required timescales.

We contacted commissioners of the service and asked them for their views of the service. Commissioners are people who work to find appropriate care and support services for people. We also contacted Healthwatch Northamptonshire, an independent consumer champion for people who use health and social care services, to obtain their views about the care provided at the service. We received positive feedback from commissioners.

We spoke with one person who was living at the service. Although they were not receiving any personal care, they were able to comment on the staff and the systems in place within the service. People receiving personal care chose not to speak with inspector about their experience of living at Together Nest Lane.

We spoke with five staff members, the deputy manager, home manager, peer support co-ordinator and mental health practitioner. The registered manager was not present during our inspection.

We reviewed two people's care records to ensure they were reflective of their care needs. We reviewed three staff recruitment files, and other documents relating to the management of the service such as maintenance records, audits, feedback from people using the service and meeting minutes.

Updated 29 January 2019

Together Nest Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Together Nest Lane is located in Wellingborough and is registered to provide accommodation and personal care to people with mental health needs and younger adults. It provides care for up to eight people. At the time of the inspection five people were living in the home, two of these people were in receipt of personal care.

Together Nest Lane offers recovery-focused support for 12-36 months to people that have moved from hospital or a secure unit. The home assists people to understand their thoughts and emotions, and to identify how these impact on their behaviour. People are supported to develop strategies to manage their thoughts and emotions.

Together Nest Lane was inspected on the 17 November 2015 and rated Good. The last inspection was undertaken on the 21 November 2017. At the time of this inspection personal care was not being provided to people living at the home and the inspection was not rated. This comprehensive inspection took place on the 3 and 4 January 2019 and was announced.

A registered manager was 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 fully aware of their legal responsibilities and was committed to providing excellent leadership and support to staff.

The registered manager was knowledgeable about all aspects of the service. The provider had robust systems and processes in place to monitor the quality of the service. The management team were continually striving to make improvements by seeking feedback from people, and staff and reviewed areas of improvement during regular clinical governance meetings.

People received care and support from a staff team that were inspired and had a positive sense of direction and strong leadership to give people an enhanced quality of life. The vision and values of the provider in providing high quality person centred care was central to the ethos of the service. People’s care was centred around them as individuals and they were fully engaged in making decisions about their care. Without exception staff and the management team actively supported people’s independence and meeting their hopes and dreams. Assessments and care plans considered people's values, beliefs, hobbies and interests along with their goals and aspirations for the future.

People were treated with kindness, compassion, dignity and respect. Their rights to privacy and freedom of choice were fully upheld. The provider was committed to ensuring they had the right staff with the right approach and understanding to meet people's individual needs.

People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to report any concerns of abuse. Risks to people's safety were comprehensively assessed to ensure they were effectively managed. The provider was proactive in considering other factors that may cause people distress and supported them to develop coping strategies.

People were protected by safe recruitment procedures to ensure staff were suitable to work in care services. Staff received in-depth training for their role and received ongoing support and supervision to work effectively.

The provider worked in partnership with other healthcare professionals and external agencies to continuously provide a service that was based on best practice, and actively sought their feedback to continuously improve the care provided.

The provider had systems in place to assess and identify the support people required before receiving care from Together Nest Lane. People living at the home were fully engaged in directing their care and their choices were respected by staff working at the home. People had personalised their rooms with their own belongings.

People were supported to have maximum choice and control of their lives and supported them in the least restrictive way possible; the polices and systems in the service supported this practice.

Staff embraced peoples social and cultural diversities, values and beliefs. The management team provided training to staff and people living in the home regarding people’s values and beliefs so people knew how to support each other.

People’s concerns were responded to promptly and addressed through a formal complaints process.