This inspection started on 11 July and was concluded on 24 July 2018. It was an announced visit to the service. This was the first inspection since the service was registered to provide personal care. Ashridge Home Care Limited 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 and younger disabled adults. It focuses on providing live-in care workers, but it also provided hourly support. At the time of the inspection 16 people were supported by the service.

The service had 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.

Where people required support with managing and taking their prescribed medicine, processes and records did not always provide sufficient guidance for staff or followed national guidance and the provider's policy. We found where people required medicines for occasional use, no additional guidance was given to staff on when and how their medicines should be given. Medicine administration records were not routinely completed with all the required information. This had the potential for mistakes to occur.

Risks posed to people as a result of their medical conditions were not routinely assessed and considered. We have made a recommendation about this in the report.

Some records relating to people’s care were not always updated in a timely manner, some records gave conflicting information and had not been signed or dated. We have made a recommendation about this in the report.

People were protected from the risk of abuse, staff had received training and were knowledgeable about what do to in the event of a safeguarding concern being raised.

People were supported by staff who had received appropriate support by their line manager.

People were supported to maintain good health and were referred to healthcare professionals when a change in their condition was noted.

People told us they were treated with kindness, respect and compassion. Comments from people included “Yes, they (Staff) are very respectful of my home,” “I cannot complain, all very respectful” and “Absolutely, the house is hoovered every day.”

Care workers understood how to promote people’s choice and independence. Comments from care workers included, “To exercise anyone’s choice and control I need to give them opportunity to make simple day-to-day choices, for example discussing their likes and dislikes and asking them what they would prefer to eat or wear, if they’d like to go for a walk or prefer to stay at home.”

People and their relatives told us they received a personalised service. One person told us. “I have someone who comes each week. We have a chat and decide what we are going to do, they have been this week and we had a nice lunch together and went to Marlow.”

The service was aware of the Equality Act 2010. They supported a same sex couple with some respite care. To enable the staff to have a better understanding of the person’s needs, the registered manager had attended a conference arranged by nationally recognised charity supporting same sex couples.

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

We found the registered manager and senior management team open and welcome to our feedback. Some quality assurance processes were in place; however, they did not always pick up areas of improvement.

You can see what action we told the provider to take at the back of the full version of the report.