Aspire 2B Care

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. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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.

Systems were in place to report accidents and incidents. There was a very low level of events reported due to the needs of the people receiving care and support. People had access to professionals, family and friends outside of the service who they could raise concerns about safety with. The service had a clear process for complaints and concerns and demonstrated a transparent and open approach to listening and responding.

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.

Continuity of care was maintained by ensuring good communication between staff, people and relatives. Where needed some people had accessible hospital passports, to support them if they required medical treatment. The provider was proactive and regularly supported people with routine healthcare appointments, to ensure they had the emotional and practical support they needed. We saw evidence of good collaboration with other agencies.

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.

There were clear processes in place to manage safeguarding events and the provider worked collaboratively with the local authority to support people safely. Staff had received safeguarding training and understood how to recognise and report poor care and abuse. People and relatives told us they felt safe. Comments included, “[Name of relative] is very safe and protected from risks when the carers are present.”

The provider did not always work well with people to understand and manage risks.

Risks to people’s health, safety and wellbeing were assessed. Key risks such as falls and skin integrity were assessed. There were also specific risk assessments in place, when required, for specific health conditions and activities such as swimming. However, there was no documented evidence risk assessments had been recently reviewed. There were different formats for assessing the risks people were exposed to, and the quality of the content was variable. Some risk assessments lacked detail and required additional information to ensure risks were fully assessed. However, staff told us they were kept up to date about any changes in people’s needs through good communication. People and relatives also confirmed they received care and support in a safe way.

The provider did not always detect and control potential risks in the care environment.

Some people’s care records did not contain environmental risk assessments, to inform staff about any risks associated with supporting people in their own homes. The provider acknowledged this and we were assured this would be addressed. When we returned on the second day of the assessment the provider had started work with people and their families to ensure environmental risks were individually assessed.

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

Recruitment was managed safely. Staff received induction and training to be able to carry out their role. However, staff had not all received regular supervisions, and the programme of spot checks had not been carried out consistently to evidence staff competency and skills were monitored. The provider addressed this immediately and booked in sessions with people and scheduled an enhanced programme of observations.

People and their relatives’ reported staff were well trained, responsive, and understood the individual needs of their loved ones. Comments included, “The carers are definitely confident, professional and always well trained to do the work.” Relatives also said the provision of consistent core staff teams greatly contributed to continuity of care. The monitoring system to check call times was not robust. The provider took action to address this and showed us how they would develop their electronic systems to monitor arrival and departure times for staff. However, despite the lack of robust monitoring we received very positive feedback from people and relatives about staff timekeeping and reliability.

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.

Processes were in place to ensure people were protected from the risk of infection. Care plans included information about personal protective equipment and staff reported they had adequate supplies to support people safely. However, the provider had not maintained regular spot checks on staff’ standards and competency in this area.

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.

Overall, we concluded medicines were managed safely. Not all the people who received support required assistance from staff with their medication. Most medication administration records (MARs) were printed but 1 handwritten MAR did not follow best practice guidance. The instructions were not clear, and the medication had not been booked in and checked by 2 staff.

Staff had received up to date training to safely administer medication, but their competency had not been annually reviewed in line with best practice guidance. We were assured this would be addressed by the provider.

People and relatives did not express any concerns about how staff administered medication and indicated it was given on time.