Archived: Ashwood Care

There was a registered manager 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 provider was also the registered manager.

At our last inspection we found breaches of Regulations 12, 14, 17 and 18 Health and Social Care Act, Regulated Activities Regulations 2014 and one breach of Regulation 18 Registration Regulations 2009, Notifications of other incidents. These concerns related to risks to people’s safety, risks to people’s food and hydration needs, ineffective monitoring systems, staff training and failing to notify CQC of reportable events. At this inspection we found improvements had been made

and the service improved from Requires Improvement to Good.

People told us they benefitted from caring relationships with the staff. There were sufficient staff to meet people’s needs and people received their care when they expected. Staffing levels and visit schedules were consistently maintained. The service had safe, robust recruitment processes.

People were safe. Staff understood their responsibilities in relation to protecting people from the risk of harm. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

Where risks to people had been identified most care plans had appropriate risk assessments in place and action had been taken to manage the risks, although some still required updating. At the time of our inspection, care plans and risk assessments were being reviewed and updated. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicine as prescribed.

Staff had a good understanding of the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The provider was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

Most people told us staff were mostly punctual and they were generally informed if staff were running late. Records showed there were no missed visits.

People were treated as individuals by staff committed to respecting people’s individual preferences. The service’s diversity policy supported this culture. Care plans were person centred and people had been actively involved in developing their support plans.

People told us they were confident they would be listened to and action would be taken if they raised a concern. We saw a complaints policy and procedure was in place. The service had systems to assess the quality of the service provided. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the provider. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the provider was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the managers and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

Ashwood Care provides personal care services to people in their own homes. At the time of our inspection there were 80 people receiving care and support from the service. They were supported by 20 care workers, a supervisor, an office co-ordinator and a registered manager.

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 service had a process in place to assess the risks to the health and well-being of people and staff. However, once identified there was not always clear guidance to ensure that the risks were managed safely. Staff demonstrated a good understanding of how to protect people from abuse and avoidable harm and the provider had suitable processes in place if staff needed to report any concerns. Safe recruitment practices were followed to ensure staff were suitable to work in a care setting. There were enough staff to support people safely. People were supported safely to take their medications and medication administration records (MAR) charts were completed fully.

Staff did not all receive regular mandatory training to ensure they maintained the skills and knowledge to carry out their roles effectively. Where people required support to maintain their nutrition and hydration, charts were not always completed appropriately. Supervision, observation checks and appraisals were completed regularly. Consent was sought from people before personal care was provided. Staff demonstrated a good knowledge of the Mental Capacity Act and how to apply this in everyday practice.

Safeguarding notifications were not sent to the Commission. Auditing to monitor and improve the quality of service provision was not undertaken effectively. Staff felt well supported by the registered provider. People and staff received questionnaires to provide feedback about the service .

People were positive about the care they received. Care was provided by regular staff who knew people well, and with whom they had developed a good rapport. People's dignity and privacy was respected. Care calls were occasionally late but there were no missed calls.

The provider’s initial assessment, care planning and reporting systems resulted in people receiving care and support that met their needs and was delivered according to their preferences. People were supported by staff who knew them well as the provider ensured that there was consistency in staffing people’s calls. People knew how to make a complaint if they had any concerns. Complaints were logged, investigated and followed up.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the end of the full version of this report.

We spoke with four staff and the registered manager of the service. All staff told us they had received induction and appropriate training to enable them to do their job. All staff told us they enjoyed working for the company and felt they were well supported in their role.

The agency had suitable arrangements in place for obtaining, and acting in accordance with, the consent of people in relation to the care and treatment provided for them. We saw signed consent forms relating to care, treatment and the sharing of information. We were told by people that used the service that the agency always listened to what they had to say and had sort consent to carry out care and support. We were told by a relative that "communication with the agency was good and changing the service was very easy to do"

Records showed that there were comprehensive support plans for people that use the service, which had appropriate information and documents relating to the care and treatment provided. Staff records were detailed and comprehensive.

Complaints were logged and their outcomes recorded, people who used the service told us they knew how to make a complaint and felt that the agency would act upon it.

People’s needs and wishes were recorded in a plan of care that is kept under regular review. Risks to people’s safety are assessed and plans to reduce and monitor risks to both people using the service and staff were recorded.

Records showed that the staff team had received safeguarding training and those that we spoke to were aware of how and when to report any concerns. People using the service told us. “Sometimes if they do get it wrong, the office is very prompt to respond and they put it right very quickly”.

In order to protect the people using the service, we saw that the agency carried out a rigorous staff recruitment process and staff received training suitable to their role.

People that we spoke with were very positive about the staff team and comments included. “They are absolute gold, second to none.” Also. “They are always very polite and very positive."

There were processes in place to monitor the quality of service being provided and we saw that people were involved through questionnaires and spot checks.

A family member told us “Some of the staff has been with my relative for seven years, we trust them, they take their time and are very supportive.”