Aspire Home Carers Limited

Updated 24 May 2022

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 carried out by one inspector 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post. A branch manager ran the service on a day to day basis.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with two people and three relatives about their experience of the care provided. We spoke with three staff, the new branch manager and the registered manager. We reviewed a range of records. This included two people’s care plans and associated risk assessments and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We looked at training data, meeting minutes and quality assurance records.

Updated 24 May 2022

About the service

Aspire Home Carers Limited is a domiciliary care agency providing support to people in their own homes. At the time of our inspection there were 11 people using the service. Some people were living with dementia. Not everyone who used the service received personal care. The Care Quality Commission (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.

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

People were not supported by staff who had been recruited safely. There were gaps in new staff's previous employment history which had not been explored and references had not been consistently obtained.

Risks had not been consistently assessed in line with best practice. For example, people and staff had not been individually assessed for the risks of COVID-19. Staff did not consistently record the actions taken when there had been concerns about a person’s health.

The registered manager did not have clear oversight of the day to day running of the service. There had been several changes in branch management in the previous 12 months. People told us the communication was not good. Checks and audits were not robust, and the registered manager had not reviewed the audits to check they were effective.

The service was actively recruiting for staff. Office staff covered care calls to make sure people received the support they needed. People told us that generally staff were on time and they stayed the length of time they should. People and relatives said they were contacted by the service if staff were running late.

People were supported by staff who understood how to keep them safe. Staff understood their responsibilities around the risks of discrimination, abuse and harm. People told us they felt safe having staff coming into their homes to support them. One person said, “I trust them with all my heart.” A relative said, “[Staff are helpful and caring. I feel safe knowing they are there for [my loved one]. They use a stick and a walking frame and staff support them when they are moving round the house.”

People received their medicines as prescribed. The service used an electronic system which alerted office staff if a medicine was not signed as administered. This enabled them to double check, and if necessary, take action quickly. People and relatives told us staff wore gloves, face masks and aprons when they visited.

A new branch manager had been recruited and had already identified shortfalls. They prioritised obtaining feedback from people, relatives and staff to begin to drive improvements. Staff felt the service had improved since the new branch manager had started working at the service and felt confident this would continue. Staff felt valued and believed their opinions and ideas were listened to.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 5 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about the day to day management of the service. As a result, we undertook a focused inspection to review Safe and Well-Led only.

We have found evidence that the provider needs to make improvements. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aspire Home Carers Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment practice and good 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.