Ash Care Services Salisbury Limited is a domiciliary care service that provides personal care and support to people in their own homes.

At our last inspection we rated the service good. At this inspection, we found the service had deteriorated to Requires Improvement.

The registered manager had completed some checks to ensure the quality and safety of the service but these were not always documented. Records did not show the action the registered manager had taken, to minimise the reoccurrence of an incident.

People’s medicines were not always safely managed.

People were asked to give their views about the support they received but their feedback was not coordinated. This did not give an overview, which could be used to further develop the service.

People were happy with their care and received a reliable service. There were no concerns about staff being late or not arriving. People were supported by a consistent team of staff who knew them well. Established relationships had been built and there were many compliments about the caring nature of staff.

There were enough staff to support people safely and effectively. Staff had received training related to their role and were well supported by each other and the registered manager.

People were appropriately assessed before being offered a service. Each person had a support plan in place, which detailed their needs and the support they required. Whilst the information clearly identified the tasks staff were to complete, it was not always person centred. We made a recommendation to develop this area.

People were appropriately supported with meal preparation and had enough to eat and drink. Staff promoted people’s rights to privacy, dignity and independence.

People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

Further information is in the detailed findings below.

This inspection took place on 26 July 2016 and is the first inspection of the service. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a domiciliary care service. We wanted to make sure the manager, or someone who could act on their behalf would be available to support our inspection.

Ash Care Services Salisbury Limited is a small domiciliary care agency, which provides care and support to people in their own homes on a short and long term basis. The agency currently supports people in Salisbury and the surrounding villages.

This agency was first established in 2014. The agency had a registered manager in place. 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 registered manager was present throughout the inspection.

People were complimentary about the service they received. They said the service was responsive to their needs and all visits took place at a time, which was convenient to them. Staff arrived to support people on time and no missed visits were experienced. People were supported by a small team of staff who knew them well. They were always introduced to a new member of staff so were never supported by staff they did not know. Each person had a detailed support plan, which informed staff of their needs and the support required. Care was regularly reviewed to ensure it remained effective. People were aware of how to make a complaint but did not feel the need to do so. They were happy with the support they received with their meals and the management of their medicines.

There were enough staff to support all care packages provided. Staff were given sufficient time with people and enough time between visits for travel. This meant they were rarely late and did not arrive to people feeling stressed. To ensure continuity, the registered manager or deputy manager undertook all visits when staff were on leave or unwell. More staff were to be recruited if the numbers and complexity of care packages increased. Staff told us they received sufficient training to help them to do their job effectively. They were confident when talking about how they kept people safe. Staff told us they were very well supported and received regular informal and formal support from the management team.

The agency was well managed, with clear leadership and an understanding of people’s needs. The registered manager had a strong value base which was implemented by staff throughout their work. Systems had been developed to ensure the smooth running of the service. This included effective scheduling of people’s visits and good communication with the staff team. There was clear monitoring of the service through discussions with people and observations of staff practice. The registered manager regularly met with people or undertook their support to assess the quality of the service they received. Specific audits were in the process of being developed.