Aspirations Birmingham

Updated 15 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by 2 inspectors and an Expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in several ‘supported living’ settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. During the inspection another registered manager was registered meaning there were 2 registered managers sharing management responsibility for the service.

Notice of inspection

This inspection was announced. We gave a short notice period of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 7 December 2022 and ended on 13 January 2023. We visited the location’s office on 7 December 2022 and 12 January 2023. We visited people on 8 December 2022. Phone calls were made to relatives on 7 December 2022. We undertook phone calls to staff and healthcare professionals during various dates and remotely reviewed records.

What we did before the inspection

We reviewed information we had received about the service since their registration. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met and spent some time with 7 people who were supported by the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke with 4 relatives about the experience of the care provided over the telephone.

We spoke with 14 support staff, 1 supported living manager, 2 registered managers, regional director, director and head of quality. We also spoke with 3 healthcare professionals and 2 social workers.

We reviewed and sampled a range of documents and records including the care records for 7 people, 4 staff recruitment files and training records. We also looked at records that related to the management and quality assurance of the service.

Updated 15 February 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Aspirations Birmingham is a ‘supported living’ service that provides personal care and support to people living in their own homes. The service supported people with mental health needs, people with a learning disability and/or autism.

At the time of the inspection the service supported 36 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. The service supported 8 people who received personal care at the time of our inspection.

People were supported both in the community in their own houses and some people lived in a converted building that used to be a residential care home. For some people staff provided 24-hour care which included sleeping or waking night staff at the person’s home.

People’s experience of using this service and what we found

Right Support:

People did not always receive the support they needed to keep them safe from risk of harm and which ensured all their needs were met. People were supported by the number of staff they needed but these staff did not always know people well which impacted on the support they received. Improvements were required to ensure people received the support they needed to manage and monitor their healthcare needs. The way people were supported with their medicines needed improving to ensure people only had medicines when they needed them and to ensure this was kept under regular review.

Not all people were supported to have maximum choice and control of their lives. Not all staff supported people in the least restrictive way possible and in their best interests; Policies and systems in the service did not always support this practice.

Right Care:

People were not always supported in a way that promoted their dignity, privacy and human rights. Support provided to some people was not always person centred. However, this was not the experience for all people supported. People’s core staff were described as kind and caring, and they were passionate about improving people’s life experiences and support.

Right Culture:

The provider did not always promote a positive culture as staff did not always feel supported and communication was not always effective and inclusive. Systems in place did not always ensure complaints were managed and responded to effectively and in a timely way. Lessons learnt from these and other sources of feedback were not always embedded, to enable improvements to be made to improve outcomes for people.

The providers systems and processes were not effective in enabling the provider to identify where improvements were needed and to take action to address these in a timely manner.

The provider had an improvement plan in place which was updated to include the feedback we shared during and following our inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection;

This service was registered with us on 23 August 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns we had received about people’s care, such as medicines management, infection control issues, staffing and governance issues. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to management of risk and medicines, complaints and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.