The inspection took place on 7 and 8 January 2019. The inspection was announced.

This service is a domiciliary care agency. Expertise Homecare (Ashford) is a care agency that provides care services to people in their own homes. It provides a service to a broad variety of people including older adults, people with dementia, learning and physical disabilities and younger adults. Not everyone using the service received a regulated activity of 'personal care.' CQC only inspects the service being received by people provided with ‘personal care’. At the time of inspection, 53 people were receiving personal care at home.

The service was run by a company who was the registered provider. There was a registered manager in post who was also a director of the company. 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. In this report when we speak about both the registered provider and the registered manager we refer to them as being, 'the registered persons'.

This was the first time Expertise Homecare (Ashford) had been inspected and given a rating following its registration with us in January 2018.

Some risks had not been appropriately assessed and measures were not in place to reduce them.

Staff received training in how to safeguard people, however, referrals or discussions did not always take place with the local authority safeguarding team when needed.

Most medicines were managed safely; people received their medicine when they were supposed to, but further guidance was needed to make sure staff knew if some people had prepared their medicine correctly.

Care plans detailed how people wished to be supported. Most people’s end of life wishes were discussed with them or their relatives and recorded.

The registered persons understood their legal responsibilities to notify CQC about important events, however, this had not happened on one occasion.

People and their relatives told us they felt safe and comfortable when staff visited them, they spoke highly of the staff and the dedication and care they showed.

The provider had quality assurance processes in place. These included gaining people’s views about the service, how the service could be improved and a positive culture of learning from mistakes. However, some quality assurance processes needed further refinement to ensure they achieved the improvement identified.

There were sufficient staff available to provide the service needed and they had received the training required for their role. Thorough checks made sure new staff were suitable to work with people.

People were supported to be as independent as possible, including involvement in meal planning, preparation and shopping, as well as keeping their home clean and doing their laundry. People were supported to maintain their health, access health services and were given advice about healthy eating.

People were offered choice, staff understood the principles of the Mental Capacity Act 2005 and how to put them into practice.

People benefitted by being support by staff who were understanding, kind and compassionate. Staff knew people well including their preferences and supported people’s individuality and diversity. Staff consistently demonstrated they shared the provider's vision and values when delivering care and communicating with people and their relatives.

Staff followed the provider's infection control policy. This had been recorded by the registered persons when they carried out observations on staff.

A complaints procedure was provided in formats people could understand. People and their relatives were aware of how to make a complaint.

Staff felt well supported by the management team. People and their relatives felt the servic