Ashlong House Domiciliary Care Agency provides personal care and support services to people with learning disabilities, complex mental and physical needs living in their own homes. The agency is owned by Allied Care Limited. Services are currently provided across the counties of Kent, Surrey, Sussex, Essex, Hampshire, Oxfordshire, and Devon. Packages of care and support are based on individual needs and visits range from one hour to 24 hours.

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 and associated Regulations about how the service is run. The registered manager was supported by a project manager based at each location known as hubs. The registered manager was present for the duration of the inspection.

The service’s risk assessment process enabled people to take risks as safely as possible. The risk assessments identified risks and provided guidance for staff to manage these safely without compromising people’s independence.

Arrangements for the administration of medicines were in place which ensured that people received their medicines safely and in an appropriate way. Some people were able to manage their own medicines.

Staff recruitment processes were safe. Appropriate checks, such as a criminal record check, were carried out to help ensure only suitable staff worked in the service. Staff met with their line manager on a one to one basis to discuss their work. Staff felt they had the necessary support to undertake their roles.

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

Staff were aware of their responsibilities regarding safeguarding people from abuse and were able to demonstrate what they would do if they suspected abuse had taken place. They had access to a whistleblowing policy should they need to use it.

People’s privacy and dignity were respected. People felt they were treated as individuals and that staff respected them when visiting them in their homes. Gender specific staff were provided for people who made a specific choice and people’s information was handled confidentially.

Staff supported people to keep healthy by encouraging them in their choice of nutritious foods. People were either supported or supervised in their menu planning and shopping.

People had access to health care professional and staff supported people to have regular health checks and to attend appointments and clinics as appropriate. When people lived with anxieties or required specialist intervention they had the support of clinical experts for advice and guidance.

When people had individual activity plans the agency provided support for them to follow these. This included supporting people to attend college, plan and shop for food and take part in leisure activities.

Staff had followed legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

There were sufficient numbers of staff provided to meet people’s needs and support their activities. Staff were allocated at individual hubs either to visit people independently or in supported living homes.

The registered manager and project managers undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were actioned by staff.

If an emergency occurred people’s care would not be interrupted as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was available in a format that was easy for people to

People we spoke with told us that the service “Is very good” and “Staff are great they support me really well” and “They’re always there when I need them” and “They are the best care team I’ve ever had.”

People we spoke with told us they were involved in making decisions about their care and treatment. They said they regularly had meetings with their care managers to make sure they had the support they needed.

People who used the service told us they felt safe with the staff who looked after them and that if they had any concerns they could speak to the manager of their house.

Staff and people who used the service told us they were regularly asked for their opinions and views about the service provided by the agency.

People who used the service provided by Ashlong House Domiciliary Service told us that they were involved in making decisions about the care and support they received and felt that they were well supported by the agency. They told us that they were happy with the personal care that staff provided and their privacy and dignity was respected. People using the service said they felt safe and secure with their carers. One person told us, “they always treat me with respect”. Another person told us, “they have helped me to cook, look for jobs and help me get up in the morning”. Another person who uses the service told us, “ “my carer is very efficient and treats me with respect and understanding, she knows me really well and I feel safe with her”.

People who use the service and their relatives told us they were always involved in making decisions about the care and support they or their relative received and felt they were being well supported by the agency. People directly receiving support in their own homes said they were very happy with the care the staff provided and felt their privacy and dignity was being respected. Several people using the service mentioned that staff are always very patient and encouraged them to do what they could for themselves. Some people told us about the range of activities they were supported to take part in and how agency staff were helping them develop their daily living skills. Relatives said that when complaints had been made or concerns raised with the manager or staff, these had been taken seriously and acted upon straight away. People using the service said they felt safe with their carers as they knew most of them very well. Relatives and advocates said they had developed good working relationships with the manager and other agency staff, which benefited people using the service.

We looked at the medicine administration records and medicines supplies for the six people who had their medicines given to them by care staff. We saw there were appropriate arrangements were in place for recording the administration of medicines. This meant people received medicines as prescribed.

The people, who used the service,we spoke with told us they had no problems with their medicines and staff gave them their medicines when they needed them.