Ashwood Care

At our last inspection in April 2017 we found breaches of Regulation 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in Good Governance and Personal Care which related to fit and proper persons employed, staff supervision and training and quality assurance systems to assess, monitor and improve the quality and safety of the service. Following that inspection we asked the provider to complete an action plan to identify what they would do and by when to improve the key questions- Is the service safe, effective, well led.

The action plan submitted identified the service had implemented robust recruitment and selection processes, updated training and personal development systems and commenced a quality monitoring procedure. At this inspection, we found that all the required improvements had been made.

Ashwood care is a domiciliary care agency based in the Padgate area of Warrington. It provides personal care to people living in their own houses and flats in the community. The services provided include care and support provision for older people, people with a physical or learning disability, people living with dementia, children and end of life care.

At the time of our inspection, the service offered support to 60 people who lived in the Warrington area.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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.

Recruitment processes were robust and ensured that staff were of suitable character to work with vulnerable people. All staff had been subject to a check by the disclosure and baring service (DBS) and had also been required to provide two references.

Discussions with staff members identified that they felt happy and supported in their roles. They told us that the registered manager was supportive and they felt that they could contact her and the office staff at any time.

Staff had received the training they required to carry out their roles effectively and new staff had also been supported to undertake a period of induction. This helped ensure that staff had the skills they needed to support people.

Records showed that staff carried out their home visits at the agreed time.

Systems were in place to check the quality and safety of the service. The registered manager also sought feedback from people informally on a regular basis and on a formal basis annually. All the feedback we viewed was positive. Spot checks and observations were carried out with staff to ensure that the standards of care were maintained.

People were protected from the risk of abuse. Staff had completed training in safeguarding vulnerable adults and knew how to respond to and report any concerns they may have.

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.

Care records contained personalised information about people's needs which helped ensure that staff had access to up-to-date and accurate information around people's support needs. This helped ensure that people received the correct level of support.

Medication administration records (MAR) sheets held details of types of medication and the times they were to be given. However although all records viewed held details of the administration of medication there were some inconsistencies in the recording such as gaps being left on the MAR sheets when medication was not required. This was discussed with the registered manager and refresher training was immediately arranged for all staff to ensure they were compliant with the agency medication policy which detailed how all MAR sheets should be completed.

There were clear lines of responsibility within the service and the registered manager worked positively with the local authority and other professional services in order to develop and drive improvement.

The five questions we ask about services and what we found