Nestora Home Care

The provider had not operated robust systems and processes to assess, monitor and improve the quality and safety of the service. They had not maintained accurate and complete records. The provider did not sufficiently address all the concerns raised from the last inspection. Audit systems were not robust and governance systems failed to identify the issues we found during the inspection.

The provider had not met all of their statutory requirements. The provider had failed to notify the CQC of a change of the provider's registered address and a change to their statement of purpose.

People were protected from the risks of abuse and harm and people said they trusted staff to keep them safe. Staff had received training in safeguarding adults and understood how to recognise signs of abuse. Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff had the necessary safety checks in place before starting work and completed a full induction.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation about the provider considering best practise and training for completing mental capacity assessments

People told us staff were kind, courteous and sensitive. People's comments included, "They [staff] are caring" and "They [staff] are all nice and cheer me up."

People told us the care workers arrived on time to deliver their care, and if they were delayed people were informed of this. We received mixed feedback about the continuity of care workers. Some people told us they received regular care workers and other people felt there was no continuity.

Staff had received end of life training and the service worked closely with healthcare professionals to deliver

end of life care should people wish to remain at home. We have made a recommendation about the provider reviewing their processes to give people the option to make their end of life wishes known.

Staff felt valued and supported by the management team. They were clear about the culture of the organisation and what was expected from them. Staff told us, "Management are really good. Really supportive and helpful."