We carried out a review of the data available to us about Ashbourne Quality Care Ltd 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 Ashbourne Quality Care Ltd, you can give feedback on this service.
Ashbourne Quality Care Ltd is a domiciliary care provider. It provides personal care to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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. At the time of our inspection, 28 people were receiving a personal care service.
People’s experience of using this service and what we found
Improvements had been made since the last inspection. There was sufficient evidence to demonstrate audits and actions were being completed. However, these were not fully embedded to provide us with the assurances they were robust enough, or sustainable. We have made a recommendation about reviewing the auditing process of incidents and accidents to ensure clear outcomes are recorded and any lessons learned are documented.
There were enough staff to effectively meet the current packages of care for people’s needs. People were supported by staff who had the knowledge and skills to ensure they were safe from harm. Risk assessments had been completed, to assess and reduce any risks associated with the required support.
People were supported by a regular team of care staff, people said they usually received their calls on time. When people required assistance to eat or drink, the provider ensured this was planned to meet their preferences and their current assessed need. People had support when required, to liaise with healthcare professionals to ensure they remained well.
People had developed caring relationships with staff, and people told us they treated them with respect. People were appreciative and spoke fondly of staff who provided their care.
The provider had developed good working relationships with other health and social care professionals to support the needs of people using the service.
There were systems in place to support and drive improvements. People were involved in their care and were asked for feedback to support the development of the service.
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.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ashbourne Quality Care Ltd on our website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 18 February 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The overall rating has changed from Requires Improvement to Good. This is based at the findings on this inspection.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
Ashbourne Quality Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults in and around Ashbourne. At this inspection there were 19 people receiving a service. The organisation provides other support that is not regulated by us, including support in the community.
People’s experience of using this service:
Quality monitoring systems were not in place to ensure people received safe care. The provider had not implemented systems to monitor how the service was delivered to provide effective oversight.
A comprehensive plan of care had not been developed for people and risks to their health and well-being were not always identified, assessed or managed. People did not always receive their medicines as prescribed and necessary checks to ensure safe medicines systems were not in place.
People’s diverse needs had not always been assessed to ensure staff had guidance of how to meet these needs and achieve positive outcomes. Care reviews were completed, although care records did not reflect changes to how people wanted to be supported.
Where people may have experienced of potential harm, effective systems were not in place to ensure these were suitably investigated. The providers’ policies and procedures did not always reflect current legislation or best practice guidance.
Staff had received a care induction and had opportunities for further training. However, staff did not receive formal supervision to review how they provided care and to discuss their personal development.
People had regular staff who provided their care and they felt they had developed positive relationships. The staff arrived on time and stayed for the duration of the call. If staff were running late they were informed of this. People had not experienced any missed calls, or calls later than the timeframe staff were expected. Staff treated people with respect, dignity and encouraged independence.
People felt the staff listened and made choices about their care. 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.
Rating at last inspection:
The last rating for this service was requires improvement (Published 1 January 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to how people were protected from harm and how care was planned. Systems and processes were not in place to ensure effective oversight of the service.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
The service had a manager in place at the time of our inspection. 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.
The quality monitoring systems did not always identify where improvements were needed and some records relating to people and the management of the service were still not available. We did not receive notifications of significant events to show how the provider had responded and improvements were needed with how information was handled, to ensure it was always kept securely.
Improvements were needed to ensure people were supported to have maximum choice and control of their lives. Improvements were needed to ensure capacity was assessed and decisions made in people’s best interests. People were actively involved in making choices and decisions about how they wanted to live their lives.
Risks to people’s health and wellbeing were assessed and plans were in place to monitor people and to assist them in a safe manner. The staff understood how to protect people from harm and were confident that any concerns would be reported and investigated by the registered manager. Some people received assistance to take medicines and records were kept to ensure that this was done safely. There were safe recruitment procedures in place to ensure new staff were suitable to work with people. Staff felt supported by the registered manager and enjoyed working in the service.
Staff were supported and trained to ensure that they had the skills to support people effectively. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed need. People were able to make decisions about how they wanted to receive support to ensure their health needs were met.
Care was planned and reviewed with people and the provider ensured that people’s choices were followed. People’s privacy and dignity were respected and upheld by the staff who supported them. People felt comfortable with staff who they knew and satisfied with the support provided.
The support plans reflected people’s specific needs and preferences for how they wished to be supported and were reviewed with them regularly. People felt comfortable raising any issues or concerns directly with staff and there were arrangements in place to deal with any complaints.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
The service provides personal care and support to people who live in their homes in and around the Ashbourne area of Derbyshire. At the time of this inspection nine people received support from the agency, seven of whom received support with their personal care needs.
The service is required to have a registered manager. 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. At the time of our inspection there was a registered manager in post.
Improvements were required to some records to ensure they were accurate and complete; including medicines administration record (MAR) charts and care plans. In addition, some checks on the quality and safety of services and records to show all stages of the recruitment process had been followed had not been retained.
People felt safe with the support they received from the service. Staff had been trained and understood their responsibilities for safeguarding people. There were sufficient staff deployed to meet people’s needs.
People were cared for by staff who were caring, kind and gentle. Staff promoted people’s dignity and privacy. People were involved in planning and reviews of their care and support and their views were respected.
People received personalised and responsive care and were involved in reviewing what care they needed.
Staff sought people’s consent before they provided care. The provider had a policy and procedure in place on the Mental Capacity Act 2005, should a person not have the capacity to consent to their care.
Staff were aware of people’s healthcare needs and supported people to access other healthcare provision when required. Risks associated with people’s care were identified and well managed.
Staff understood how to support people with their nutrition and hydration needs and how to meet their known preferences.
Staff had been trained in areas relevant to people’s needs. Training for more specific areas of care was also in place to support staff competence in these areas.
Staff felt supported by the registered manager and had regular team meetings.
People knew how to raise any worries or concerns should that be needed.
The registered manager was approachable and involved people and staff in how to develop the service.
At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.