Archived: Aspects Care Limited - Grimsby

Updated 17 October 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. This service currently provides care and support to people living in one ‘supported living’ setting, so 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.

The service did not have a manager registered with the Care Quality Commission. 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. The service was being managed by a manager from another of the provider’s services.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started and finished on 1 August 2019. We visited the office location on the same day.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with three people that used the service, the manager and three support staff. We reviewed three people’s care records. These included medication administration records and daily notes. We looked at four staff recruitment, induction, training and supervision records as well as other records relating to the management of the service.

After the inspection

We looked at some specific information we had asked the provider to send us. This included staff start dates, staff security check dates and the staff training record.

Updated 17 October 2019

About the service

Aspect Care Ltd – Grimsby is a domiciliary care service providing care and support to older people and younger adults, as well as people who may be living with a learning disabilities or autistic spectrum disorder, dementia, mental health need, or a physical disability.

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. At the time of our inspection only three people were being supported with personal care.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control and choice. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

At the last inspection the provider had rushed recruitment processes so that the service sometimes let staff start shadowing before their checks were through or references were confirmed. Staffing numbers were insufficient and care coordinators were relied on to make visits and so worked extra hours. People did not have the benefit of a quality assurance system that identified shortfalls in all areas of the service or that were analysed for trends and reported on. We made recommendations about these.

People’s experience of using the service and what we found.

At this inspection, while some improvements were made, people did not always have the benefit of a service that was positive, inclusive and forward-looking. There was no registered manager for the past 12 months. This had been an unsettled period for everyone, due to a lack of direction for staff, some of whom had left along with the previous manager. People received an inconsistent service with these changes and the increased use of agency staff. Ineffective checks on how well the service was provided meant the quality assurance and monitoring systems were still ineffective. People had not always experienced support with independence. People told us they were not encouraged to live as independently as they wished to.

People continued to receive a good service in other areas. They were safe from harm. Systems and appropriately recruited staff supported this. People's risks were safely managed. Sufficient numbers of staff were employed to support them in taking risks. People were safely supported with handling medicines and with keeping their home clean.

Staff were trained, skilled and well supported by the provider. People had good relationships with the staff who protected their rights to lead a normal life in many areas. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us staff were kind and caring. People said their privacy and dignity were respected and staff were discreet.

Staff were now motivated to provide person-centred care based on people's choices and preferences. Staff had experienced an unsettled period where direction was missing. They were now demonstrating a change in attitude because supervision and guidance from the manager had improved. This meant people were better supported to do the things they wanted to. Any dissatisfaction in receiving the service was addressed and resolved.

Documents held in the office were secure to ensure confidentiality of people's information.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control and choice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice, control and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills.

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

Rating at last inspection

The last rating for this service was requires improvement (published 23 August 2018), but there were no breaches of regulation. Since this rating was awarded the service has moved premises.

We have used the previous rating to inform our planning and decisions about the rating at this inspection, where we found there had been some improvement in the areas we identified last time. However, insufficient improvement in one area meant a new breach of regulation was identified.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.