We carried out a review of the data available to us about Ashwood Care Leigh 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 Ashwood Care Leigh, you can give feedback on this service.
Ashwood Care is a domiciliary care service providing personal care to 137 people living in their own houses and flats in the community and specialist housing at the time of the inspection. It provides a service to older adults, younger adults and people with dementia, mental health conditions, sensory impairments and physical disabilities.
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 using this service and what we found
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 were supported by a small group of regular staff which provided continuity and familiarity and people’s comments confirmed this approach. Staff had developed relationships with people and knew them well; people received person-centred care as a result.
Staff supported some people to access other healthcare professionals when required. Staff supported a small number of people to manage their medicines safely.
People were supported in a friendly and respectful way. People and their relatives were complimentary about the staff and their caring attitude.
Systems were in place to recruit staff safely; there were sufficient numbers of trained staff to support people safely. Recruitment processes were robust and helped to ensure staff were of suitable character and had relevant experience to work with vulnerable people.
Staff had awareness of safeguarding and knew how to raise concerns. Steps were taken to minimise risk where possible.
Staff promoted people's independence and treated them with dignity and respect. People were involved in making decisions about their care and involved in reviews to ensure their care plans met their needs and supported them to achieve outcomes. Staff supported some people to access the community.
People’s needs were comprehensively assessed before starting with the service; people and their relatives, where appropriate, had been involved in the care planning process.
Staff were competent and had the skills and knowledge to enable them to support people safely and effectively. Staff received the training and support they needed to carry out their roles effectively and received regular supervisions and annual appraisals; this was confirmed by staff we spoke with.
People’s care plans were person-centred, and outcome focussed and provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences. There was evidence that care plans were reviewed regularly or as people’s needs changed.
People knew how to make a complaint. There was an effective complaints process in place to deal with any complaints that might be raised in the future.
The registered manager and staff were committed to providing high quality care and support for people.
The service had an open and supportive culture. Systems were in place to monitor the quality and safety of care delivered. There was evidence of improvement and learning from any actions identified.
The provider and registered manager followed governance systems which provided effective oversight and monitoring of the service.
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 for this service was requires improvement (published 01 October 2018) and there were two breaches of regulations.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.
Why we inspected
This was a planned 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.
Not everyone using Ashwood Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, the service offered support to 170 people who lived in the local authority area.
During this inspection we found two breaches of regulations in relation to safe care and treatment and good governance.
Medicines were not consistently administered in a safe way. Some medication administration records (MAR’s) had no dates recorded on them. One person had missed a supplement for one week, another person’s medicine had been started but had ran out. There were missing signatures on some MAR charts. One person’s medicines were all crushed and mixed with water and taken in a syringe but there was no mention or reference to this process anywhere in the MAR or care notes. When visiting people at home we found a strip of one medicine had been placed in a box of a different medicine, which meant the person could have been given the wrong medicine at the wrong time. Some MAR’s contained handwritten information on the back which was poor practice and confusing to understand.
These issues meant there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because medicines were not consistently managed safely. You can see what action we told the provider to take at the back of the full version of the report.
Although medicines were audited and staff were subject to observations of practice and spot checks these interventions had failed to identify the issues we found during the inspection regarding the safe management of medicines.
These issues meant there was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance. You can see what action we told the provider to take at the back of the full version of this report.
There was 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.
People who used the service and their relatives told us they felt safe receiving support from Ashwood Care and staff understood the principles of keeping people safe.
Recruitment processes were robust and ensured that staff were of suitable character to work with vulnerable people.
Care files contained risk assessments which determined the level of risk and the control measures required to manage the risk.
There was an appropriate, up to date accident and incident policy and procedure in place. Records we saw indicated no serious accidents had occurred.
People told us they considered staff to be knowledgeable and skilled in meeting their needs and confirmed the care workers and other staff they met were competent. Staff told us they had enough time when visiting people to effectively meet people’s needs and people told us staff stayed the full length of the visit but could sometimes be late.
Newly recruited staff were required to undertake a probationary period before being offered a permanent position, which included observed practical assessments before confirmation in their role. Staff induction was aligned with the requirements of the Care Certificate, where appropriate. Staff were receiving the appropriate range of training to enable them to carry out their job effectively.
Staff we spoke with confirmed they received regular one to one supervision and told us that any problems were quickly sorted out.
The service gave people the appropriate support to meet their healthcare needs. Staff liaised with healthcare professionals to monitor people's conditions and ensure people health needs were being met. People stated they were offered a choice of food and enjoyed the food provided.
Staff told us that if they had any concerns about the capacity of a person using the service, they would contact the office. We saw where people lacked capacity this was clearly recorded within their care plan.
People who used the service and their relatives told us care staff were kind, caring and helpful and treated them with respect. Most people using the service and their relatives felt the care staff were approachable, listened to them and acted in accordance with their wishes. Most people we spoke with told us staff respected their privacy and dignity and felt they encouraged them to be as independent as possible.
We found the service aimed to embed equality and human rights though good person-centred care planning. People's confidentiality was protected. Records containing personal information were being stored securely.
People we spoke with who used the service and their relatives confirmed they had been involved in planning their care and each person who used the service had a care plan in place that was personal to them. People could receive information in formats they could understand such as in easy read or large print.
The provider had a complaints policy and processes were in place to record any complaints received. People we spoke with told us that they knew how to complain and had details of how to make a complaint.
End of life care had been discussed with people who used the service, where they agreed to discuss this and staff had received training to enable them to support people as part of a multi-disciplinary team when required.
The staff we spoke with spoke positively about how the service was run. Staff told us the registered manager was supportive and considered their welfare.
We saw that staff meetings were held regularly and staff had the opportunity to raise any issues. We saw spot checks and direct observations were carried out with staff to ensure that standards of care were maintained.
The service’s aims and objectives were referenced in the statement of purpose and were based on offering a professional and effective service to the people who used it and acting as a good employer to staff.
We found the service had policies and procedures in place, which covered all aspects of service delivery
The registered manager, who was supported by an operations manager, worked with the local authority and other professional services to develop and drive improvement.
Results of the most recent questionnaires and surveys received where mostly complimentary about the service, but some people or their relatives had concerns about some staff who they told us did not always understand their care needs.
There was an up to date provider and manager registration certificate on display in the office premises along with an appropriate certificate of insurance.