The inspection took place on 7, 8 and 9 January 2019 and was announced. We announced the inspection as we inspected the Ascot House rehabilitation service as part of the same inspection. This was to allow us to see how people transitioned from Ascot House to the Care at Home service. We also needed to ensure there was someone available to facilitate the inspection.

Ascot House – Care at Home is a domiciliary care service. It provides personal care to people following a period of rehabilitation in Ascot House. The service provides support to people in their own homes on a short-term basis to enable them to continue to gain confidence and improve levels of mobility.

This was the first inspection since the service was registered with the Care Quality Commission (CQC) in January 2018.

A registered manager was 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 felt safe being supported at the service. Staff had received training in safeguarding vulnerable people from abuse and were confident any concerns they raised would be listened to and acted up on. Any safeguarding concerns had been reported to the local authority promptly.

Staff were recruited safely. Appropriate checks were in place to ensure staff were suitable to support vulnerable people.

People had the risks they presented assessed and reviewed and were involved in the process. People were supported with equipment to help them reduce levels of risk and as their mobility improved. Equipment was identified for use prior to being discharged to people’s homes.

People received on-going assessment prior to using the service and throughout the period of support to ensure people’s mobility and independence improved. Access to primary care services such as GP and other health professionals remained involved once people return home and staff consulted with them when required.

Staff received training appropriate to their job role. Training was delivered via e-learning or face to face. Staff told us the training was good and enable them to carry out their role.

Where people needed support with food preparation and meals. This was captured in the care plan. People told us staff were supportive when assisting with meal preparation.

People told us they felt cared for and the staff were kind, caring and showed privacy and dignity. Staff we spoke with could describe how to protect people’s privacy and dignity and enjoyed seeing people improve to enable them to stay in their own home.

Peoples personal information was kept secure in people’s homes or a secure office. Information was shared with agreement from people on a need to know and confidential basis.

Care plans captured people’s needs and what interventions were required to promote independence. Care plans set agreed goals for people to work towards.

Complaints were actioned and responded to in a timely manner. People were aware who they should contact in the event of wishing to make a complaint.

Staff felt very supported by the manager of the care at home service. They received regular supervision and appraisal to ensure they could effectively carry out their job role. The manager was supported by the registered manager who also has overall responsibility for Ascot House and the care at home service.

Feedback from people was very positive and 100% of respondents said they rate the service as good or excellent. The service had received many compliments thanking the staff team for their care and support.

The manager completed a number of audits to monitor and improve the service. Audits highlighted areas for improvement. The manager completed unannounced checks when staff were supporting people reviewed care files