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Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about 268 Ashingdon Road on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about 268 Ashingdon Road, you can give feedback on this service.

Inspection carried out on 24 May 2019

During a routine inspection

About the service:

268 Ashingdon Road is a domiciliary care agency that provides personal care to people living in their own homes. At the time of inspection 12 people were using the service.

People's experience of using this service:

People told us they felt safe using the service and valued the fact that they were supported by regular care staff who knew them well. People said they never had a missed call, staff arrived on time and stayed for the full length of the arranged visit and provided support in the way they wanted. People told us that the registered provider who was currently managing the service was helpful and approachable. People told us they had no complaints, were happy with the service they received and would recommend the service to other people.

Risks to people had been assessed with guidance for staff to follow. However, improvements were required in terms of risk recording to make sure people's care records were up to date and reflected people's current needs. Medicines were managed safely by staff who had been trained and assessed as competent. Staff had access to protective clothing to prevent the spread of infection. Sufficient staff were employed who had been safely recruited.

Staff received training, supervision and regular observations of their practice to ensure staff had the knowledge and skills to care for people effectively. People received support to have enough to eat and drink that met their needs and preferences. Staff knew people well and reported any health concerns to the registered provider who made appropriate referrals.

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

People told us staff were kind and caring and treated them with dignity and respect. Staff were gentle and compassionate when providing care and support and listened to people. Independence was supported and encouraged.

Improvements had been made to how information about people was collected to help staff get to know people and how they wanted their care and support delivered. There were systems in place to respond appropriately to complaints. Staff had received training in end of life care and feedback from people showed that people and their families received kind and compassionate care.

The registered provider was managing the service whilst a new manager was completing their induction and going through the registration process. Improvements had been made to ensure robust quality assurance mechanisms were in place to monitor the safety and quality of the service. The registered provider had a good level of oversight of their service as often worked out in the field providing care and support to people and overseeing staff practice. They were pro-active at seeking the opinion of people and staff to drive improvements and ensure people were happy with the service they received.

Rating at last inspection: Requires Improvement. (Last report published June 2018).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service.

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

Inspection carried out on 11 April 2018

During a routine inspection

This inspection took place on the 11, 16, 18 and 20 April 2018 and was announced. We gave the registered provider 48 hours’ notice to make sure someone was available in the office to meet with us.

This was our first inspection of the service since it was registered with the Care Quality Commission in May 2017. 268 Ashingdon Road is a domiciliary care agency that provides personal care and support to people living in their own homes. Most people using the service were older people with palliative care needs. There were seven people receiving a service at the time of our inspection.

At the time of inspection there was no registered manager in post. The registered provider had been the registered manager but had resigned from the position but was still actively involved in running the service. A new manager had been recruited who was going through the registration process. 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.

Risks to people had been assessed with guidance in place for staff on how to manage them. However, risks to people's home environments had not been adequately considered.

We made a recommendation about assessing risks in people’s homes.

People’s needs had been holistically assessed, however we found there was insufficient written guidance recorded in people's care records for staff to follow.

We have made a recommendation about the quality of information held in people’s care records.

Staff training needs had not always been identified or training provided to ensure staff had the necessary skills and knowledge to meet people’s needs. However, plans had been put in place to address this issue.

Staff had not received formal supervisions, annual appraisals or observations of their practice which help services to monitor staff performance and identify any learning needs. However, staff felt well supported and had access to informal and ad hoc support and advice as needed.

Where people had specific communication needs these had not always been assessed and recorded.

We have made a recommendation about inclusive communication practices.

Care plans were task-focussed and did not always contain sufficient information to support staff to provide individualised care.

We have made a recommendation about the provision of person-centred care.

Most people who used the service received palliative care and the service ensured they had access to treatment and support from health professionals to keep them comfortable and pain free. However, people’s care records had not captured their wishes and preferences for their end of life care.

We have made a recommendation about end of life care planning.

The provider had not ensured that the quality and safety of the service was monitored robustly. Oversight of the service and staff team was not always sufficient to identify areas that required improvement.

We have made a recommendation about quality monitoring and oversight of the organisation and staff team.

There were sufficient numbers of staff who had been safely recruited to meet people’s needs. Staff had been trained in how to safeguard adults from abuse and understood how to report concerns to keep people safe.

Medicines were safely managed as staff had received training from the provider who had checked to ensure staff were competent to administer people’s medicines.

People were supported to have enough to eat and drink and maintain their health and wellbeing. People's consent to care had been sought and staff understood how to help people living with dementia make their own decisions.

Staff were kind and caring. People were supported to be as independent as possible by regular staff that knew them well and had formed pos