Aspire Care Services Ltd

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• 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. At our last inspection, we rated this key question inadequate.

At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At the last inspection the service was in breach of regulation 12 for safe care and treatment. At this assessment, enough progress had been made, and the service was no longer in breach of this regulation.

This service scored 69 (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 and their relatives told us they believed any safeguarding concerns would be suitably investigated by staff or the management team if required. One person said, “I have never had any concerns to raise with the management, I feel protected from risks.”

Staff told us they were confident if they raised safety incidents with the management team, these would be suitably investigated. We reviewed, minutes of staff meetings which supported that discussions around accidents, incidents, preventative measures and improving the service was discussed regularly.

The service had an accident and incident, and complaints policy in place.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and their relatives were involved in the creation of their care needs before an agreement for care to be delivered was made. One person said, “The provider did involve me in the planning of care when I started using the [service].”

Care plans and risk assessments had enough information to ensure a smooth transition if people had needed to move between services. The service worked well with healthcare professionals to ensure people received support from external partners as required.

Staff felt communication was effective when new people were being supported with the service. A staff member said, “All needs are assessed by management. However, we also carry out assessments during shifts, which are logged and reported to management.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider demonstrated an adequate understanding of the Mental Capacity Act (MCA) 2005. Staff had received training in the Mental Capacity Act and knew how to support people accordingly under this act. One staff member said their understanding of the Act was, “The Mental Capacity Act helps people make their own choices. If someone cannot make a decision, they should be supported and the decision should be made in their best interests.”

The service had policies in place regarding the safeguarding of adults and whistleblowing with guidance for staff to follow to keep people safe.

People and their relatives told us they felt safe with the care that was delivered by Aspire Care Services Ltd. One family member said, “I am extremely satisfied with the care my relative is getting. My relative is kept safe and is not vulnerable to risk.”

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.

Care plans contained enough information to inform staff how to manage risks and keep people safe from avoidable harm. Care plans were created and reviewed with people, and their relatives on a regular basis.

People told us they were involved in the creation and reviewing of their care plans and risk assessments. They felt staff were fully equipped to support them with their care needs. One person said, “The provider did involve me in the planning of my care. I had a care plan put together. I feel I have a lot of control over the care I get and can voice my opinions.”

The provider did not always ensure potential risks in the care environment were assessed and reviewed to prevent the risk of avoidable harm.

Environment risk assessments lacked important information, such as fire alarms and locations of exits in people’s homes. Some people who required additional support with mobility had no evacuation support plan in place. This meant staff were not informed how to evacuate people safely if the need arose in an emergency. We raised this concern with the registered manager. The shortfall in the quality of the environment risk assessments was acknowledged. The provider told us these would be revised to ensure importing information was noted.

People told us staff maintained a clean environment when they were supported. One person said, “Staff have a very high standard of hygiene. They keep the environment clean.” Another person said, “Staff are also very tidy and clean.”

One person said, “[Staff] keeps the environment clean, and always checks for spillages.”Staff had received training in first aid, food and hygiene and safe environments.

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.

While there were pre-employment checks in place, staff had not provided full employment histories as part of the recruitment process. This meant recruitment was not fully compliant in line with current guidance and best practice. This put people at risk of being supported by staff who had not been fully assessed to ensure they were safe to provide care and support. We discussed this with the registered manager, who gathered people’s employment histories during the assessment.

Recruitment records showed staff had induction sessions at the beginning of their employment, and regular supervision sessions. Appropriate employment checks such as, right to work in the UK, Disclosure and Barring Service (DBS) checks and suitable references had all been obtained.

The provider ensured staff received appropriate training to help them support people in a safe manner. People and their relatives told us they thought staff were well trained and able to do their job well. One member of staff said, “I received an induction, training and face to face meetings before people were met.”

The provider did not always assess or manage the risk of infection.

We received mixed feedback on how staff managed the prevention of infection control. One person said, “The [staff] keep forgetting to bring gloves, so I have to go out and buy them.” Another person said, “They forget to wear gloves.” This was fed back to the registered manager who assured us there was no reason for staff not to have gloves, due to a good supply available at the service. PPE could also be dropped off to people’s homes on request. The registered manger told us this concern would be investigated to prevent repetition.

However, many people were happy with how staff managed infection, prevention and control. We received the following comments, “[Staff] wear gloves, aprons, shoe covers and carry hand sanitizer. and “The hygiene standards are very good. [Staff wears all the protective clothing at all times.” And “They all wear the PPE and keep the environment clean.”

The service had an infection, prevention and control policy in place which guided staff on steps to take to reduce the risk of spreading infection. Staff had also received training in infection control.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

At the last inspection, information on medicine administration records (MAR) charts was not clear. There was no assurance people had received their medicines on time or as intended by the prescribing GP. This meant the provider was in breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this assessment, enough improvement had been made. People’s medicines were clearly recorded, and we received positive feedback from people.

People told us staff supported them well with their medicines. One person said, “Staff help me with my medication…they watch me to make sure I take my tablets.” A relative told us, “[Staff] make sure [relative] gets [medication] on time. The staff deal with the pharmacy, order medication and collect it when it is ready.”

We saw records to support all staff had received training in medication delivery. They had regular competence and compliance checks. Staff attended refresher courses in medicines administration annually.