The inspection took place on 8 September 2017 and was announced. The provider was given 48 hour notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office.

Aspirations Support is registered to provide a personal care service to people living in their own homes. There were four people receiving support with personal care.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

At this inspection it remained Good.

Why the service is rated good

At the last inspection, the service was rated Good. During this inspection we found the service remained Good. The service remained good because risks to people were assessed with appropriate plans in place to keep them safe. Where incidents occurred, actions were taken to prevent them from reoccurring. People’s medicines were administered safely by trained staff. Staff understood their role in safeguarding people from abuse. The provider carried out appropriate checks to ensure staff were of good character. Staff were deployed in a way that meant people’s needs could be met safely. Call times were monitored to check that staff arrived and left their care visits so that people were safely supported with their care at the right time.

People were supported by staff who had received sufficient training and were supported with their on-going learning and development needs to carry out their roles. Staff worked in accordance with the Mental Capacity Act 2005, this meant that people’s legal rights were protected. People's consent was sought before care was carried out and their decisions about this were adhered to. People were supported to prepare food in line with their dietary requirements and preferences. Staff worked alongside healthcare professionals to meet people’s needs.

People were supported with kindness and compassion by staff that knew them well. People were involved in their care and their independence was encouraged. Staff were respectful and promoted people’s privacy and dignity.

Care plans were person centred and reflected people’s individual personalities and interests. People had access to a range of activities that they enjoyed. People were supported to complain if they wished to. Any complaints were responded to appropriately.

Measures were in place to involve people and staff in the running of the service. Regular checks were carried out in people's homes to make certain staff were following the correct procedures to monitor the quality of the care that people received. The provider kept up to date records that were easy to access.

We asked the staff how they ensured the person they supported was treated with dignity and respect. They gave us a number of examples to demonstrate to us their understanding and commitment to uphold these values.

We spoke to the relative of the person using the services of Aspirations Bristol. They said “the staff that visit are polite, caring and support my relative extremely well”.

We looked at the documentation that the provider had in place to direct and guide staff practice. We saw that the person had a well written, detailed personal care plan in place which identified the assessed needs of the person. The care plan had been written in such a way that the person who used the service was at the centre of the plan and their individual preferences were highlighted and easy for staff to identify.

We found that staff were very clear about what action they would take if they saw or suspected any abuse.

Appropriate recruitment checks had been undertaken before staff began working for Aspirations, Bristol.

The provider had a statement of purpose that contained clear information about the services provided. This was kept under review.

Aspirations Support Bristol provides domiciliary care services to people with a learning disability and, or a mental health condition, who live in their own homes, in the South Gloucestershire and Bristol area. They provide supported living support and personal care support to enable people to live independently without total reliance on parents or guardians. Aspirations Support Bristol are registered with the Care Quality Commission to provide the regulated activity Personal Care. Other services provided by the service do not come within our remit. At the time of this inspection five people were receiving personal care from the service.

There was a registered manager in post. There is a condition of registration that the regulated activity of personal care is managed by an individual who is registered with CQC as a manager. A registered manager has the legal responsibility for meeting the requirements of the law; as does the provider.

People were safe because they were looked after and supported by staff who had a real passion to ensure they were not harmed. Risk assessments and management plans were in place to reduce or eliminate any risks to people’s health and welfare that had been identified. When any new risks were identified further management plans were put in place.

Staff recruitment procedures were thorough and ensured that only suitable workers were employed to look after the vulnerable adults. All staff received safeguarding adults training to ensure they were familiar with safeguarding issues and knew what to do if concerns were raised.

People were provided with the support they needed to manage their medicines. Staff received training in the safe administration of medicines and managers checked regularly to ensure they remained competent to administer medicines. Changes were needed in the way that people were supported to reorder their medicines. People were living in their own homes but the staff were following residential care home procedures. There were no risks to people however people need to be supported individually.

People received the care and support from a team of staff who had the required skills, knowledge and personality to meet their particular needs. All staff completed a programme of essential training and also ‘person specific training’ based upon the needs of the person they were looking after.

People were unable to give consent to the care and support they were provided with. Mental capacity assessments had been completed as part of the overall assessment process. Where decisions needed to be made by others, best interest meetings had been held with other relevant parties. Agreements were made about how people needed to be looked after and how this support was to be provided.

People were supported to eat and drink and to maintain a healthy body weight. The level of support each person needed was detailed in their plan of care. People were supported to access health care services if needed.

People were supported by an identified team of staff to ensure good working relationships were established. This ensured people were cared for consistently as the staff knew them. People were treated with kindness and respect. Staff took account of people’s behaviours and used this as feedback and ‘having a say’ about how their care needs were to be met. People’s preferences and choices were respected.

The service was well-led and people, their families, guardians and others involved in their care were encouraged to provide feedback. The quality and safety of the service was regularly monitored and used to make improvements. The registered manager has an action plan in place to further drive improvements.