Aspire Care Services Ltd

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.

Aspire Care Services Ltd is a domiciliary care agency. It provides a personal care support service to people in their own homes. At the time of the inspection the service was providing personal care for 52 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.

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

People did not always receive care and support from staff that received adequate time off. We have made a recommendation about staff deployment.

The oversight and monitoring of the service was not always effective. Monitoring of staff calls was not robust and we could not be assured that sufficient numbers of staff were deployed to keep people safe.

People received their medicines as intended. People and their relatives told us risks were managed safely and regularly reviewed. Staff received training in safeguarding and knew how to identify, report and escalate suspected abuse. There were good infection control practices in relation to COVID-19.

Staff confirmed the registered manager was approachable and people told us their views were sought to drive improvements. The registered manager was aware of their responsibilities in line with legislation and was keen to continue to work in partnership with stakeholders.

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 22 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and 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.

We have found evidence that the provider needs to make improvements.

Please see the good and well-led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This comprehensive inspection took place on 30 May and 5 June 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related

to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the service were providing personal care to four people.

This was the provider’s first inspection since their registration

The service did not have a registered manager in place. At the time of the inspection the manager had submitted an application to the Commission to become registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Although people’s medicines were administered as intended by the prescribing G.P, on the first day of the inspection we identified medicines administration records did not always contain sufficient information, in line with good practice. We shared our concerns with the manager, who on the second day of the inspection had developed a detailed medicine recording chart to remedy this issue. We were satisfied with the manager’s response.

The provider had developed risk management plans that were detailed and reviewed regularly, however guidance for staff on managing identified risks was not always clear. We raised our concerns with the manager on the first day of our inspection. On the second day of the inspection the manager had devised a clearer format enabling staff to swiftly identify guidance on mitigating those risks. We were satisfied with the manager’s response.

The provider did not have robust systems and processes in place to effectively monitor the service on the first day of the inspection. Auditing processes were not in place in relation to medicines management, risk assessments and care plans. We raised our concerns with the provider and on the second day of the inspection the provider had developed processes to ensure the overall governance of the service was regularly reviewed, monitored and action taken to drive improvement.

People were protected against the risk of abuse as staff received on-going training in safeguarding and were aware of the provider’s procedure in responding, reporting and escalating suspected abuse. Staff were aware of the provider’s safeguarding policy and were confident concerns raised would be acted upon in a timely manner.

People received care and support from sufficient numbers of familiar staff. The provider’s employment checks ensured staff were safe to work at the service, prior to delivering care. Staff received on-going training to effectively meet people’s needs. Training included, safeguarding, medicines management, Mental Capacity Act 2005 and moving and handling.

Staff were supported to reflect on their working practices through regular supervisions. Staff were also received support and guidance from the management team who were regularly available in the main office or on the phone at any time.

Staff and the manager were aware of their roles and responsibilities in line with the Mental Capacity Act 2005. People’s consent to care and treatment was sought prior to care being delivered. People had their privacy respected and their dignity maintained and people and their relatives described staff as respectful, caring and excellent.

People were protected against the risk of cross contamination because the provider had systems and processes in place to manage infection control. Where agreed in people’s care packages, people received support from staff members to make and prepare meals that met their dietary needs and requirements.

People received personalised care that was regularly reviewed to reflect their changing needs. Care plans were detailed and gave staff clear guidance on how to meet people’s needs in line with their preferences.

Where agreed in their care plans, people were supported to participate in activities both in house and in the local community. People were encouraged to raise their concerns and complaints. The provider had a complaints policy in place.

Relatives and healthcare professionals spoke positively about the service and found the management team responsive to their needs.