Ash House

Updated 27 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive, announced inspection. We gave short notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to talk with people receiving a service.

This inspection took place on 3 and 4 April 2018. The inspection team included one adult social care inspector.

Prior to the inspection, we looked at previous inspection reports. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events, which the service is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Prior to the inspection we had sent questionnaires to seven people using the service, and one was returned. Seven out of 13 sent to staff were returned. Seven ‘friends and relatives’ and one community professional were sent questionnaires and none were returned.

During the inspection we visited one person and telephoned six others. We interviewed three toe nail cutting assistants, a team supervisor, and were assisted with information from the registered manager and Age UK Somerset administration team.

We reviewed four people’s records and two staff records. We saw records of staff meetings, and looked at quality monitoring information. We received information and professional feedback from a member of the Somerset Partnership Foundation Trust podiatry department.

Updated 27 April 2018

Ash House is run by Age UK Somerset who have been contracted by the Somerset Partnership Foundation Trust to provide a toe nail cutting service for people in Somerset. People assessed by Somerset Podiatry service as not requiring health care intervention, but who cannot manage to cut their own toenails, have the option to receive that service from Age UK Somerset. This can be in clinics (which were not included in this inspection), or in their own home if they are housebound. The service is administered from Ash House and comprises a supervisor and team of toe nail cutters. 98 People were using the service at the time of this inspection.

Rating at last inspection

At our last inspection, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good

Robust staff recruitment procedures protected people from harm. The service understood how to protect people from abuse and discrimination.

The staffing arrangements were flexible and the toe nail cutting assistants arranged appointments according to people’s individual needs, which promoted people’s comfort and safety.

People were protected from infection and cross contamination when receiving the toe nail cutting service.

Toe nail cutting assistants were trained to be alert to health conditions which might pose a risk to people, and make appropriate referrals. A podiatrist said that the referrals they received from toe nail cutting assistants were always appropriate.

Toe nail cutting assistants understood that people should consent to receiving the service and how to respond if consent was not provided.

People were treated with respect and dignity. Kind and friendly rapport helped people feel valued and people said how much the service helped them maintain their independence. One person’s family member said, “They help (the person) and me as well.” People’s views were sought through the service supervisor visits and feedback questionnaires. The one complaint relating to the toe nail service in people’s homes had led to positive change.

People, and toe nail cutting assistants, were protected through records of the care they received, and any issues which might pose a risk. The standard of record keeping, and information from the records, was monitored to improve the service, as was any incident which occurred.

Toe nail cutting assistants received observation supervision and there were plans to provide face to face supervision in a private setting, and a yearly appraisal. They said they felt supported and managers were always available to talk to.

The aims and objectives of the service, to improve the lives of people over 60, were uppermost in the culture and practice of the organisation.

Further information is in the detailed findings below.