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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 Ashfield Care Ltd 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 Ashfield Care Ltd, you can give feedback on this service.

Inspection carried out on 4 March 2019

During a routine inspection

About the service:

Ashfield Care Ltd provides care and support to people in their own homes in the Ross on Wye area. At the time of the inspection the service supported 39 people.

People’s experience of using this service:

People told us they felt well cared for by staff who treated them with respect, dignity and encouraged them to maintain relationships and keep their independence for as long as possible. One person who used the service said, “They all bar none are so kind and take an interest in me, so yes they do treat me so well.”

People who used the agency and relatives told us they felt confident in the management team and how the service operated. They told us good staffing levels afforded people responsive and dignified support.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

Risk assessments had been developed to minimise the potential risk of harm to people. These had been kept under review and were relevant to the care provided.

Care plan information focused on a person-centred method of supporting people. Also, information contained what support was required for the person and consent to care evidence was seen throughout care documentation.

People’s care and support had been planned in partnership with them. People felt consulted and listened to about how their care would be delivered. We confirmed this by talking with people and relatives who used the agency.

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.

The management team used a variety of methods both formal and informal to assess and monitor the quality of the service. This enabled Ashfield Care to be monitored and improve systems and processes that were identified through their quality monitoring programme.

Rating at last inspection: Good (16 August 2016)

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

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about 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 9 December 2016

During an inspection looking at part of the service

We carried out an announced comprehensive inspection of this service on 11 July 2016. A breach of legal requirements was found in relation to failing to submit statutory notifications to the Care Quality Commission.

We undertook this focused inspection to confirm that the provider had now addressed this concern. This report only covers our findings in relation to that requirement.

Ashfield Care is located in Ross-on-Wye, Herefordshire. It is domiciliary care agency which provides support to people in their own homes. It supports people with mental health difficulties, learning disabilities, people who need end of life care, people living with dementia, and people living with conditions such as Parkinson’s disease and Multiple Sclerosis. On the day of our inspection, there were 49 people using the service.

There was a registered manager at this service, who was present on the day of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

People had been kept informed of recent changes to the management structure. People were positive about the service they received, and the way the service was run.

Staff could approach the registered manager and provider, and they felt valued and motivated in their roles.

People's views were sought about the care they received, and there were systems in place to routinely monitor the quality of care provided.

The provider had notified the Care Quality Commission of safeguarding concerns or accidents and injuries sustained by people they support, as required.

Inspection carried out on 11 July 2016

During a routine inspection

Ashfield Care is located in Ross-on-Wye, Herefordshire. It is domiciliary care agency which provides personal care to people in their own homes. It supports people with people with a mental health condition and people with a learning disability, people who need end of life care, people living with dementia, and people living with conditions such as Parkinson’s disease and Multiple Sclerosis. On the day of our inspection, there were 47 people using the service.

The inspection took place on 11 July 2016 and was announced.

There was a registered manager at this service, who was also the provider, but they were not present on the day of our inspection. Therefore, we spoke with the deputy manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

People were involved in discussions about the individual risks associated with their care needs, and agreed the steps taken by staff to minimise risks to them. Incidents and accidents were reviewed to look at whether people needed additional support to keep them safe. Staff knew how to recognise signs of abuse or harm and where they had concerns, these had been reported.

People were prompted to take their medicines. Where there were concerns about people and their medicines, these were discussed with the relevant health professional.

People received care in a manner which was in accordance with the principles of the Mental Capacity Act. People were given the information needed to make informed choices, and their choices were respected. Staff received ongoing training which was relevant to the needs of the people they support.

People received help with their meals and drinks. Where there were concerns about people’s weight loss, lack of appetite or general health, staff liaised with other health care professionals to ensure people's health and wellbeing were maintained.

People were involved in decisions about the level of care they would receive, and how they would like to be supported. People were kept informed of any changes to their care and were provided with explanations. People were treated with respect, and their privacy was upheld.

People received care which met their individual needs and preferences. Where people’s needs changed, the provider responded to these and adapted the care package in place.

Where people or relatives were dissatisfied with the care provided, they knew how to make a complaint. Complaints were investigated and reviewed and used to improve practice.

The provider had not notified the Care Quality Commission of incidents where people were at risk of harm or abuse.

People were involved in the provider’s quality checks, and were asked for their views and opinions on the service they received. Staff felt appreciated in their roles, which resulted in a positive and enthusiastic team. Although people were not clear as to the management structure of the service, they felt the service was well-run.

Inspection carried out on 17 July 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

We found that safe work practices were in place for people using the service. People told us they felt safe and trusted the staff. One person said, �I trust the staff they have been lovely�.

We spoke with staff and they told us they knew how to report any concerns or abuse. They were confident the provider would listen to them and take appropriate action to safeguard people.

Staff felt the work arrangements considered their safety. They were provided with core training including manual handling, infection control and health, safety and hygiene. This helped enable staff to carry out their role safely.

The staff and the provider understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and Deprivation of Liberty Safeguards (as they related to domiciliary care) and put them into practice to protect people.

Is the service effective?

People we spoke with told us they were pleased with the service provided and that their needs were met. People told us they had been involved in the assessment of their needs prior to accepting care from the agency. One person who had been receiving a service for three weeks told us, �They�ve been very good so far�.

The staff we spoke with understood people's care needs and the support they were to provide. They received effective support and training. This meant that people received care from staff who had the knowledge and skills necessary to carry out their roles and responsibilities.

Is the service caring?

People told us that the staff treated them with kindness and were patient. Those who were being assisted with personal care tasks said staff respected their dignity and protected their privacy.

Staff we spoke with knew the people they were caring for well, including their preferences and personal histories. One person told us, "I am quite satisfied. I get on well with all of them� and �They absolutely respect my dignity�. Another said �They don�t rush you, we sit and have a natter�. This meant that caring, positive relationships were developed between people and the staff coming into their homes.

We saw an incident record that showed a worker had been very caring. They had seen an ambulance heading towards the home of a person using the service. They had followed it and gone to assist the person who had fallen.

Is the service responsive?

People told us the service responded quickly if their circumstances changed. We saw a thank you card from December 2013 that said, �Many thanks for increasing my care hours so quickly�.

People said that they and their family were encouraged to make their views known about their care and support. This meant people were actively involved in making decisions about their care and support.

There was evidence that the service was working closely with community health professionals such as district nurses and occupational therapists (OT). This meant the service was working in partnership to help ensure people had their health needs met.

On the day of the inspection the planned training session was changed to one on challenging behaviour. This was done in response to feedback from staff about challenges they were facing.

At the inspection we found some concerns about how medication administration records were being completed. The provider responded quickly to improve arrangements.

Is the service well-led?

The service was managed by the owner who worked on a daily basis in the agency office. Staff felt well trained and supported. They always had support from the senior staff and found communication was effective.

The provider had an effective system to assess and monitor the quality of service that people received. This helped ensured people received the service they wanted.

The provider had responded positively to feedback given at the inspection in February 2014 and had made improvements.

Inspection carried out on 19 February 2014

During a routine inspection

People told us they received a high standard of service from the agency. They told us, "All the workers are very caring and they really know what they're doing", and said, "They know how to coax X (name of person) and they don't talk down to him". We saw that each person had an individual plan of care, which was regularly reviewed and updated as people's needs changed.

There were some risks associated with medicines which had not been managed safely. The manager assured us that she would make the necessary improvements promptly.

There were effective systems in place to monitor the quality of the service. People told us, "It's a well run agency, there's no doubt about that" and, "I'm completely confident that we're in good hands".