Background to this inspection
Updated
12 January 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 carried out by two inspectors.
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 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.
Notice of inspection
We gave the service 23 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 8 November 2022 and ended on 16 November 2022. We visited the location’s office on 8 November 2022.
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. 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.
During the inspection
During the inspection we contacted 16 people and spoke with 6 people and 1 relative to gather their views of the service. We also spoke with 1 local authority professional and 9 staff members, including care workers, office staff and the registered manager. We reviewed 9 care plans and six staff recruitment files. We also looked at other records relating to the management of the service, including policies and procedures, the electronic call monitoring system and the training matrix. After the inspection we continued to validate the evidence found and the provider sent us audits, electronic call monitoring records and policies and procedures.
Updated
12 January 2023
About the service
Aspire Care Service Limited is a domiciliary care agency providing personal care to people living in their own homes and flats. The service provides support to older people. At the time of our inspection there were 160 people using the service. 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.
People’s experience of using this service and what we found
People’s medicines were not managed in line with good practice. Risk assessments in place required improvement to ensure they accurately reflected identified risks and gave staff clear guidance to keep people safe. People did not always receive care and support at the agreed time in their care package.
People did not always receive a service that was as well-led as it could be. Records were not always easily accessible and governance systems in place were not robust. Partnership working required some improvement.
People received care and support from staff that knew how to identify and escalate instances of suspected abuse. Recruitment procedures in place ensured only suitable people were employed. Systems and processes in place ensured staff had up to date guidance on infection prevention and control measures.
People, their relatives and staff spoke positively about the management of the service, describing the registered manager as supportive and available.
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 requires improvement (published 19 June 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We received concerns in relation to the overall management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aspire Care Services 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 medicines management and good governance at this inspection. We have also made a recommendation in relation to staff deployment.
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.