We carried out an announced inspection of Ashwood Care on 24, 25 and 26 July 2018. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older adults, younger adults and people with dementia, mental health conditions, sensory impairments and physical disabilities.

Not everyone using Ashwood Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, the service offered support to 170 people who lived in the local authority area.

During this inspection we found two breaches of regulations in relation to safe care and treatment and good governance.

Medicines were not consistently administered in a safe way. Some medication administration records (MAR’s) had no dates recorded on them. One person had missed a supplement for one week, another person’s medicine had been started but had ran out. There were missing signatures on some MAR charts. One person’s medicines were all crushed and mixed with water and taken in a syringe but there was no mention or reference to this process anywhere in the MAR or care notes. When visiting people at home we found a strip of one medicine had been placed in a box of a different medicine, which meant the person could have been given the wrong medicine at the wrong time. Some MAR’s contained handwritten information on the back which was poor practice and confusing to understand.

These issues meant there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because medicines were not consistently managed safely. You can see what action we told the provider to take at the back of the full version of the report.

Although medicines were audited and staff were subject to observations of practice and spot checks these interventions had failed to identify the issues we found during the inspection regarding the safe management of medicines.

These issues meant there was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance. You can see what action we told the provider to take at the back of the full version of this report.

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 2008 and associated Regulations about how the service is run.

People who used the service and their relatives told us they felt safe receiving support from Ashwood Care and staff understood the principles of keeping people safe.

Recruitment processes were robust and ensured that staff were of suitable character to work with vulnerable people.

Care files contained risk assessments which determined the level of risk and the control measures required to manage the risk.

There was an appropriate, up to date accident and incident policy and procedure in place. Records we saw indicated no serious accidents had occurred.

People told us they considered staff to be knowledgeable and skilled in meeting their needs and confirmed the care workers and other staff they met were competent. Staff told us they had enough time when visiting people to effectively meet people’s needs and people told us staff stayed the full length of the visit but could sometimes be late.

Newly recruited staff were required to undertake a probationary period before being offered a permanent position, which included observed practical assessments before confirmation in their role. Staff induction was aligned with the requirem