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 11 people receiving a service. The organisation provides other support that is not regulated by us including support in the community. On our last inspection in October 2017 the service was rated as Requires Improvement; on this inspection we found improvements were still needed.

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.

This inspection took place on 15 August 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk with staff and review records. Phone calls to people and staff were completed on 16 and 17 August 2017.

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.