We carried out a review of the data available to us about Expertise Homecare (Ashford) on 6 July 2023. 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 Expertise Homecare (Ashford), you can give feedback on this service.
Expertise Homecare Ashford is a domiciliary care service providing personal care to 51 people at the time of the inspection. 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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
Staff supported people to have the maximum possible choice, control and independence and they had control over their own lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe. However, staff and people fed back that sometimes staff would run late due to travel time not being factored accordingly. People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life. People were supported to receive their medicines as prescribed.
Right Culture:
People received good quality care, support and treatment because trained staff could meet their needs and wishes.
Staff placed people’s wishes, needs and rights at the heart of everything they did. The service enabled people and those important to them to worked with staff to develop the service. Staff valued and acted upon people’s views. There were effective systems in place to learn and improve.
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 19 March 2020).
Why we inspected
We received concerns in relation to staffing, training and people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Expertise Homecare Ashford on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Peoples experience of using this service and what we found
People and their relatives told us that they liked the kind friendly nature of staff for which nothing was too much trouble, they felt comfortable with having them in their home and undertaking the most personal of care support for them.
Risks were managed appropriately for example risks to people's health and safety were assessed and steps taken to minimise risk levels. There were enough staff to cover calls, but the provider ensured there was ongoing recruitment to avoid developing gaps in care cover. People told us they predominantly had the same carers and that efforts were made to maintain continuity for them. People told us that calls were never missed although at times they might be later than scheduled and for which the office staff telephoned to alert them to this on most occasions. There was a safe system for staff recruitment. Staff were trained to administer medicines, and these were managed safely.
People were supported effectively by confident well-trained staff. There were appropriate arrangements for their induction and subsequent training to give them the skills and knowledge needed. Staff said they felt well supported by the management team and felt listened to and able to contribute to meetings. Staff understood people's health needs and were able to recognise signs of them being unwell and act to alert health professionals or relatives where necessary. People were supported to eat and drink enough.
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.
People told us they were treated well and with respect by staff, who they found caring and kindly in nature, and with whom they had established good relationships. People felt that staff upheld their dignity, and did not rush them during calls.
People referred to the service had their needs assessed and contributed to the development of their care plan. They spoke positively about the quality of the service they received and indicated they would be happy to recommended it to others and had done so. Staff received equalities training to raise their awareness and understanding of how to support people with diverse lifestyle choices.
People and staff told us they found the registered manager and provider approachable, and knowledgeable about peoples needs. People and staff found the management team approachable and easy to talk with, they felt confident any concerns they might have would be dealt with swiftly. Quality monitoring and audit checks were in place to ensure all aspects of the service were monitored and standards maintained. People, staff and professionals were invited to provide feedback about service quality and this was analysed and acted upon to improve the service people received.
For more details please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating awarded to this service was requires improvement (published 2 March 2019). The provider completed an action plan to show what they were planning to do to improve upon this. This inspection has shown that improvements have been made and the provider was no longer in breach of regulations.
Why we inspected
This was a scheduled 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.
This service is a domiciliary care agency. Expertise Homecare (Ashford) is a care agency that provides care services to people in their own homes. It provides a service to a broad variety of people including older adults, people with dementia, learning and physical disabilities and younger adults. Not everyone using the service received a regulated activity of 'personal care.' CQC only inspects the service being received by people provided with ‘personal care’. At the time of inspection, 53 people were receiving personal care at home.
The service was run by a company who was the registered provider. There was a registered manager in post who was also a director of the company. 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. In this report when we speak about both the registered provider and the registered manager we refer to them as being, 'the registered persons'.
This was the first time Expertise Homecare (Ashford) had been inspected and given a rating following its registration with us in January 2018.
Some risks had not been appropriately assessed and measures were not in place to reduce them.
Staff received training in how to safeguard people, however, referrals or discussions did not always take place with the local authority safeguarding team when needed.
Most medicines were managed safely; people received their medicine when they were supposed to, but further guidance was needed to make sure staff knew if some people had prepared their medicine correctly.
Care plans detailed how people wished to be supported. Most people’s end of life wishes were discussed with them or their relatives and recorded.
The registered persons understood their legal responsibilities to notify CQC about important events, however, this had not happened on one occasion.
People and their relatives told us they felt safe and comfortable when staff visited them, they spoke highly of the staff and the dedication and care they showed.
The provider had quality assurance processes in place. These included gaining people’s views about the service, how the service could be improved and a positive culture of learning from mistakes. However, some quality assurance processes needed further refinement to ensure they achieved the improvement identified.
There were sufficient staff available to provide the service needed and they had received the training required for their role. Thorough checks made sure new staff were suitable to work with people.
People were supported to be as independent as possible, including involvement in meal planning, preparation and shopping, as well as keeping their home clean and doing their laundry. People were supported to maintain their health, access health services and were given advice about healthy eating.
People were offered choice, staff understood the principles of the Mental Capacity Act 2005 and how to put them into practice.
People benefitted by being support by staff who were understanding, kind and compassionate. Staff knew people well including their preferences and supported people’s individuality and diversity. Staff consistently demonstrated they shared the provider's vision and values when delivering care and communicating with people and their relatives.
Staff followed the provider's infection control policy. This had been recorded by the registered persons when they carried out observations on staff.
A complaints procedure was provided in formats people could understand. People and their relatives were aware of how to make a complaint.
Staff felt well supported by the management team. People and their relatives felt the service was well run. The service worked in partnership with other organisations and sought and acted on their advice to improve outcomes for people.
The registered persons had a detailed knowledge of how the service was running; they knew people and staff very well.