Aspire South West London

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were encouraged and supported to raise safety concerns with managers and staff. They understood the importance of reporting safety concerns. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated. A senior staff member told us, “All complaints, safeguarding concerns, incidents, and accidents are recorded, investigated, and reviewed by management. Appropriate actions are taken, lessons learned are shared with staff, and improvements are implemented where necessary.” The provider used an external consultant to help them review and analyse information gathered from complaints, safeguarding concerns, feedback from service users, and quality monitoring spot checks on staff’s working practices.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People confirmed they felt involved in decisions about managing risks and were confident staff understood those risks and how to mitigate or safely manage them. One person said, “I am not very mobile and am at risk of falls, but my carer understands that and knows how to look after me keep me safe.” A relative added, “The carers know how to use my [family members] mobile hoist and how to help her stand safely. My [family member] also has issues with swallowing, which the carers are fully aware of and manage-well.”

People’s care records contained sufficiently detailed and up to date information for staff to follow. Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. A staff member told us, “I understand risks by reviewing people’s risk assessments before each home visit, and through handovers and updates from the office and people’s family. Risk assessments and management plans were reviewed at regular intervals and updated according to reflect any changes in people’s needs.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Detailed risk assessments conducted on people’s home environment ensured they were safe places to live and work. The managers collaborated with people, their relatives and, when appropriate other health and social care professionals, to ensure people had the right equipment to meet their needs. The office-based managers and supervisors routinely conducted in-person home visits which ensured they were able to identify and mitigate any potential environmental health and safety risks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were supported to continually improve in their role. They received a mixture of e-learning and in-person practical and theoretical training and competency-based assessments. One person told us, “My carer absolutely knows what she is doing. They know how I like things done and understand their job.” A member of staff added, “The training I receive helps me do my job well and to understand how to keep people safe.”

However, staff did not always receive all the relevant and most up to date training they needed. For example, staff had not received any specific or formal stoma awareness training despite supporting a person with these needs. We found no evidence that people had been harmed by this gap in staff’s knowledge and skills, but it could place a person at risk of harm. We discussed this training issue with the registered manager at the time of our assessment who agreed to ensure all staff who supported people with this health care condition received stoma awareness training within the next 3 months.

Home visits were well-organised by the office-based coordinator. People told us staff were usually punctual and had enough time to complete all the tasks they were expected to during each of their home visits. One person said, “My carer always arrives on time and stays as long as I need her to.” A relative added, “The carers arrive on time, and if they are going to be delayed, they will let me know, although that doesn’t happen very often at all.” Staff confirmed they were happy with the way their visits were coordinated. A staff member told us, “I always have ample time to sit and have a chat with people I support because I get more than enough travel time between my home visits.” The office-based coordinator added, “I coordinate staff visits carefully, taking into account locations and travel times, and the complexity of each service user’s needs. I maintain regular communication with staff throughout the day to ensure calls run smoothly and aren’t rushed.”

People received continuity of care from the same small group of staff who were familiar with their personal care needs, wishes and daily routines. One person told us, “We see the same carer 90 percent of the time.” A member of staff added, “The office coordinator makes sure I get to support the same people on regular basis. This helps me build good working relationships with people and ensures they receive continuity of care from me and my colleagues.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their line managers, supervisors and fellow co-workers. In addition, field supervisors routinely conducted monitoring visits to observe staff working practices to help them identify what staff did well and what they might do better. A member of staff said, “I have regular supervision sessions and team meetings with my line manager, which provides me with a valuable opportunity to discuss my work performance, training needs, and any concerns or ideas I might have to improve.”

The provider followed safe recruitment practices and only suitable staff were employed to work for this home care agency.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider operated effective systems to help prevent and control infection. Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading. People told us staff followed good hygiene practices and used personal protective equipment (PPE) when needed. One person told us, “The carers wears PPE when they help me to wash”, while a relative added, “The carers always have aprons and gloves.” Staff reported they had consistent access to enough PPE. A member of staff told us, “Staff in the office regularly top up our PPE and we can always call the supervisor or put in a request on the group chat to get more PPE delivered to us that same day if needed.” Senior staff routinely observed staff working practices to check they were following safe infection control and hygiene practices when they supported people.