Ashlong House Domiciliary Care

Ashlong House is a domiciliary care agency providing personal care to 203 adults at the time of the inspection. People lived in properties across East and West Sussex, Suffolk, Surrey, Brighton and Hove, Kent, Wiltshire, Oxfordshire, Hampshire and Devon. The staff worked out of “hubs” to ensure they were in close proximity to the people they support. The service focused on supporting people whose primary needs were mental health related.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People received care and support from staff who were kind and treated them with respect. Staff knew about different types of abuse and how to keep people safe. Staff received refresher training and specific training to meet the diverse needs of the people using the service. New members of staff were subject to pre-employment checks to ensure they were suitable to work with vulnerable people.

We looked at how the management team planned their rotas. Rotas were organised around a set geographical area. This ensured that people received their allocated and appropriate support from staff that were trained and best suited to their needs.

Risks associated with people’s individual care needs were assessed and plans put in place to manage these. People had been involved with the design of these care plans.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There was a complaints procedure that was made available to people and their families. The management had good oversight of the service through monitoring and auditing to ensure people received effective support. These included regular phone calls and home visits to seek people’s views about the service provided.

At the time of inspection there was a registered manager application being put forward for the Office that covered Devon, Oxfordshire and Wiltshire. This would enable more support for staff and the people using the service as the service grew.

The service worked in partnership with outside agencies, health and social care professionals to ensure people received timely healthcare support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 28 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 and associated Regulations about how the service is run. The registered manager was supported by a project manager based at each location known as hubs. The registered manager was present for the duration of the inspection.

The service’s risk assessment process enabled people to take risks as safely as possible. The risk assessments identified risks and provided guidance for staff to manage these safely without compromising people’s independence.

Arrangements for the administration of medicines were in place which ensured that people received their medicines safely and in an appropriate way. Some people were able to manage their own medicines.

Staff recruitment processes were safe. Appropriate checks, such as a criminal record check, were carried out to help ensure only suitable staff worked in the service. Staff met with their line manager on a one to one basis to discuss their work. Staff felt they had the necessary support to undertake their roles.

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

Staff were aware of their responsibilities regarding safeguarding people from abuse and were able to demonstrate what they would do if they suspected abuse had taken place. They had access to a whistleblowing policy should they need to use it.

People’s privacy and dignity were respected. People felt they were treated as individuals and that staff respected them when visiting them in their homes. Gender specific staff were provided for people who made a specific choice and people’s information was handled confidentially.

Staff supported people to keep healthy by encouraging them in their choice of nutritious foods. People were either supported or supervised in their menu planning and shopping.

People had access to health care professional and staff supported people to have regular health checks and to attend appointments and clinics as appropriate. When people lived with anxieties or required specialist intervention they had the support of clinical experts for advice and guidance.

When people had individual activity plans the agency provided support for them to follow these. This included supporting people to attend college, plan and shop for food and take part in leisure activities.

Staff had followed legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

There were sufficient numbers of staff provided to meet people’s needs and support their activities. Staff were allocated at individual hubs either to visit people independently or in supported living homes.

The registered manager and project managers undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were actioned by staff.

If an emergency occurred people’s care would not be interrupted as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was available in a format that was easy for people to understand. People were encouraged to feedback their views and ideas about the service they received.

Records management was good and showed the service and staff practice was regularly checked to ensure it was of a good standard.

The people, who used the service,we spoke with told us they had no problems with their medicines and staff gave them their medicines when they needed them.

People we spoke with told us they were involved in making decisions about their care and treatment. They said they regularly had meetings with their care managers to make sure they had the support they needed.

People who used the service told us they felt safe with the staff who looked after them and that if they had any concerns they could speak to the manager of their house.

Staff and people who used the service told us they were regularly asked for their opinions and views about the service provided by the agency.