Archived: Aspirations Northwest Adults

Updated 25 May 2016

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 announced inspection took place on 18 & 19 April 2016. ‘The provider was given 48 hours’ notice because the location provides a domiciliary care service to people who are often out during the day; we needed to be sure that someone would be in’.

The inspection team consisted of two adult social care inspectors.

The provider submitted a Provider Information Return (PIR) prior to the inspection. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before our inspection we reviewed the information we held about the agency. We looked at notifications and other information the Care Quality Commission (CQC) had received about the service. We contacted the commissioners of the service to obtain their views.

During the inspection we spent time with four people who used the services of the agency. We spoke with the acting manager, a regional manager, a training facilitator, a training manager, a deputy manager, a placement manager and four care staff/support workers. We spoke with five relatives and two health care professionals as part of our visit. The interviews with relatives, external health care professionals and staff were conducted by telephone and in person.

We viewed a range of records including, care documents for four people who used the service, four staff personnel files, medicine records, records relating the running of the service and a number of the provider’s policies and procedures.

Updated 25 May 2016

This announced inspection of Aspirations Northwest Adults took place on 18 & 19 April 2016.

There was a new manager in post who had yet to apply for the position of registered manager. ‘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’.

Aspirations Northwest Adults is a domiciliary care service providing 24 hour care, mostly within a supported living setting. The service supports people with complex mental health needs or learning disabilities.

People were administered their medicines by staff who were trained in the safe administration of medicines. We found however the medicine policy was unclear, there was a lack of information around the administration of ‘as required’ (PRN) medicines and staff competencies to administer medicines were not always checked.

We have made a recommendation around improving the safe management of medicines.

People said they felt safe when supported by the staff in their home.

The staff we spoke with could clearly describe how they would recognise abuse and the action they would take to ensure actual or potential abuse was reported. A safeguarding policy was in place for staff to refer to along with local authority guidelines for reporting an alleged incident.

Staff sought advice and support from external health professionals when needed to help assure people’s health and wellbeing.

Risk assessments were in place to ensure people’s health and safety. The risk assessments helped to help mitigate those risks and to protect people from unnecessary harm.

People had a plan of care/support plan which recorded their needs, wishes, preferences and medical history. The support plans identified the level of support people needed to maintain their health and wellbeing. Healthy eating was promoted by the staff and nutritional support given as required.

Staff sought people’s consent before providing support or care. The home adhered to the principles of the Mental Capacity Act (2005). A number of documents showed people’s consent, or relatives’ consent (if legally empowered to do so) to evidence their inclusion in the planning of care.

People were supported by sufficient numbers of staff to provide care and support in accordance with individual need.

Recruitment procedures were robust to ensure staff were suitable to work with vulnerable people. Staff files reviewed showed all relevant recruitment checks had been undertaken prior to staff starting work at the service.

Sufficient numbers of staff were available to support people in their own home. This was confirmed by talking with staff, looking at staff rotas and talking with people who used the service and their relatives.

Staff told us they were supported through induction, on-going training, supervision and appraisal. Formal supervision meetings had not been held recently for a number of staff. Following the inspection the acting manager confirmed these were being undertaken. A training plan was in place to evidence staff learning and development.

We visited some people in their own home. We saw staff speak in a gentle and caring manner. Staff took time to listen and to respond in a way that people engaged with understood. Our observations showed staff had a good understanding of the people they supported. Staff told us how they respected people’s day to day choices and they were aware of promoting good standards of dignity and respect in their work.

Maintenance and safety checks for fire safety were undertaken in people’s own home.

A process was in place for managing complaints. People we spoke with knew how to raise a concern or make a complaint. The complaints procedure along with a number of other policies were available in an easy read format to help people’s understanding.

We received positive feedback about the management of the service from people who used the service, relatives and staff.

Arrangements were in place to seek the opinions of people and their relatives, so they could provide feedback about the service. This included the provision of questionnaires and meetings. The acting manager informed us questionnaires were due to be sent shortly, as it was acknowledged this type of feedback had not been sought for some time.

Quality assurance systems and processes were in place. These were not as robust as they could be in light of our findings and also the findings from a recent service report which identified actions required in a number of areas.

We have made a recommendation around improving the current auditing systems and processes to assure the service provision.