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Inspection carried out on 19 June 2019

During a routine inspection

About the service

Ashridge Home Care is a domiciliary care agency which provides predominately live-in care workers to people in their own homes. Seventeen people used the service at the time of our visit. 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 spoke highly of their care workers. Comments included “The carers are absolutely marvellous” and “I have an excellent carer, she is exceptional, gold standard.” People told us their care workers treated them with dignity and respect. They were able to select their care workers to ensure compatibility. Staff had been recruited using robust procedures to ensure they were safe to work with people at risk.

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.

Care workers had training in key skills. Bespoke training was provided to meet the individual needs of people. Staff spoke highly of the ethos of the service and the support they received. This included regular supervision, staff meetings and out of hours back-up. Staff felt respected and valued and were clear about their roles and accountabilities.

Staff assessed risks to people and kept records up to date. Where people were supported with their medicines, this was managed safely. We saw improvements had been made to medicines practice since the last inspection.

Staff provided a high standard of care and supported people to eat and drink. Healthcare needs were met effectively. People were supported to be as independent as they could be. People’s equality and diversity needs were well met at the service.

The registered manager and other leaders ran the service well and supported staff to develop their skills. Managers monitored the service to make sure it met people’s needs in a safe and person-centred way. The provider kept us informed of any significant events. Action was taken when things went wrong or people made complaints. There was a commitment to continuous learning and developing the service to improve people’s lives.

The service worked well with external agencies to improve people’s care and raised awareness in the community about dementia and live-in care. Community professionals spoke well of the service. One described it as “Professional and caring,” another commented they had “Always been very impressed with their dedication to improving the lives of people with dementia.”

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 Requires Improvement (report published 31 August 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashridge Home Care on our website at www.cqc.org.uk.

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.

Inspection carried out on 11 July 2018

During a routine inspection

This inspection started on 11 July and was concluded on 24 July 2018. It was an announced visit to the service. This was the first inspection since the service was registered to provide personal care. Ashridge Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. It focuses on providing live-in care workers, but it also provided hourly support. At the time of the inspection 16 people were supported by the service.

The service had 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.

Where people required support with managing and taking their prescribed medicine, processes and records did not always provide sufficient guidance for staff or followed national guidance and the provider's policy. We found where people required medicines for occasional use, no additional guidance was given to staff on when and how their medicines should be given. Medicine administration records were not routinely completed with all the required information. This had the potential for mistakes to occur.

Risks posed to people as a result of their medical conditions were not routinely assessed and considered. We have made a recommendation about this in the report.

Some records relating to people’s care were not always updated in a timely manner, some records gave conflicting information and had not been signed or dated. We have made a recommendation about this in the report.

People were protected from the risk of abuse, staff had received training and were knowledgeable about what do to in the event of a safeguarding concern being raised.

People were supported by staff who had received appropriate support by their line manager.

People were supported to maintain good health and were referred to healthcare professionals when a change in their condition was noted.

People told us they were treated with kindness, respect and compassion. Comments from people included “Yes, they (Staff) are very respectful of my home,” “I cannot complain, all very respectful” and “Absolutely, the house is hoovered every day.”

Care workers understood how to promote people’s choice and independence. Comments from care workers included, “To exercise anyone’s choice and control I need to give them opportunity to make simple day-to-day choices, for example discussing their likes and dislikes and asking them what they would prefer to eat or wear, if they’d like to go for a walk or prefer to stay at home.”

People and their relatives told us they received a personalised service. One person told us. “I have someone who comes each week. We have a chat and decide what we are going to do, they have been this week and we had a nice lunch together and went to Marlow.”

The service was aware of the Equality Act 2010. They supported a same sex couple with some respite care. To enable the staff to have a better understanding of the person’s needs, the registered manager had attended a conference arranged by nationally recognised charity supporting same sex couples.

People were supported 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 found the registered manager and senior management team open and welcome to our feedback. Some quality assurance processes were in place; however, they did not always pick up areas of improvement.

You can see what action we told the provider to take at the back of the full version of the report.