Ashness Domiciliary Care

Ashness Domiciliary Care is a care at home service providing personal care to up to 11 people. The service provides support to adults with mental health needs and learning disabilities. At the time of our inspection there were 11 people using the service.

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 the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

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. Staff enabled people to access specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing. We have made a recommendation about risk assessments. 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.

Right Care:

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. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture:

People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.

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 18 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Ashness Domiciliary Care.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

This service provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. Ashness domiciliary care agency provides support to people living in Haringey with mental health needs. At the time of our inspection the service was providing support to 19 people living in the community and 10 people living in supported living accommodation. The support provided by the service includes prompting and encouraging people in areas such as, activities and taking their medication and healthy eating to manage their well-being and assist them to maintain and develop their independence.

At this inspection we found the service remained Good.

People said they felt safe using the service and the service promoted and maintained their dignity.

People received care that was safe and safeguarding practices protected people from the risk of abuse. Staff were subjected to the necessary checks before starting work. Staff received training and supervision to enable them to effectively carry out their roles. There was a process for dealing and acting on incidents and accidents. However, we have made a recommendation in relation to lessons learnt from incidents.

Medicines were managed safely and people received their medicines as prescribed. Staff wore appropriate protection equipment to prevent the risk of spread of infection.

Risk assessments were in place and identified risks posed to people and others. However, we have recommended that the service approaches a reputable source in relation to identifying and documenting specific risks such as risks related to epilepsy.

People using the service signed to give their consent to care and treatment. People are supported to maximise choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s cultural and religious needs were respected when planning and delivering care. Staff respected people’s sexual orientation and needs so that lesbian, gay, bisexual and transgender people could feel accepted and welcomed when receiving a service. People took part in a variety of activities and hobbies of their interests.

Staff told us the registered manager and other senior staff were approachable and listened to concerns. The service had obtained feedback from people using the service and carried out quality assurance in respect of service delivery.

There is 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.

This inspection took place on the 25 February 2016 and 26 February 2016 and was announced.

There were systems in place to keep people safe and people told us they felt safe and happy.

Staff attended relevant training and felt they were supported by the management team through supervision. Staff were subject to the necessary checks before working for the service.

Staff were proactive in working with other healthcare professionals to meet the individual needs of people using the service. Staff completed an annual physical health check with each person to help people to identify their health goals for themselves.

People were involved in their care and felt staff treated them with dignity and respect. Staff knew people well and had an understanding of their individual support needs. Staff provided support as required, such as reminding people to take their medicines and assisting people with cooking their meals.

Staff were responsive to people’s individual needs and their independence maintained. People were encouraged to take part in activities of their choice.

Assessments were carried out to identify people’s support needs before the support started. These had been agreed with people to ensure the agency provided the care and support people needed. Care plans identified people’s specific needs.

People’s risks were assessed and people were encouraged to take positive risks to maintain their independence. Although staff knew people well, control measures for managing risks were not always accurately documented.

People staff felt listened to and that the service was well run. Systems were in place to monitor the quality of the service.

People told us that staff supported them well with health appointments, their finances and other personal matters. They said they liked the staff and thought staff understood their needs. One person said a staff member at the supported living project was "on the ball." One person said they were "delighted with what they have done."

People felt that the provider and manager had good knowledge of their needs and were committed to the people using their service. One person said, "they do what they say they will do."

The provider cooperated with other providers to meet people's needs.

There had been a medication error prior to the inspection and improvements were needed to the recording and management of medication. The provider made the necessary improvements to protect people from the risks associated with medication.