About the service:

Aspire UK is a domiciliary care agency. It provides personal care to people living in their own houses or flats. At the time of the inspection there were 475 people using the service.

Not everyone using Aspire UK receives a regulated activity; 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.

People’s experience of using this service:

¿People told us they felt safe and confident with the staff who provided their care.

¿ People told us they were happy with the care and support they received from the service. They were keen to tell us they felt involved in how their care was planned.

¿People and family members commented on the positive impact of staff being able to communicate in people’s preferred language and how this influenced the effective delivery of care.

¿ The majority of people told us they were supported by a regular core staff team. People were keen to stress the positive impact this had on the development of relationships with staff and continuity of care.

¿ Some people told us they experienced inconsistent care when they were not supported by staff who they were familiar with.

¿Care plans in some instances provided contradictory information, which had the potential for people not to receive consistent care.

¿ Risk assessments were in place to indicate when people had been identified as being at risk. However, measures to reduce the potential risk were not directly referred to in people’s care plans, which guided staff as to how they were to provide a person’s care. The provider and registered manager said they would act to improve records detailing people’s care.

¿There were sufficient staff to care for people and no one reported having experienced any missed visits to provide their care.

¿Staff liaised with health and social care professionals to maintain and promote people’s health and welfare.

¿People's care preferences and needs and the views of their relatives were considered when their care was assessed, planned and reviewed.

¿The provider had a range of systems in place to seek the views of people and their family members.

¿ The provider worked with key stakeholders to influence and develop the service and to share good practice.

¿We found Aspire UK met the characteristics of a ‘Good’ service.

Rating at last inspection:

Good. The last report for Aspire UK was published on 20 June 2016.

Why we inspected:

This was a planned comprehensive inspection based on the rating from the previous inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Aspire provides personal care for people living in their own homes. On the day the inspection the registered manager informed us that there were 467 people receiving personal care from the service.

A registered manager was in place. 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 and associated Regulations about how the service is run. The registered manager was also the provider.

People and their relatives we spoke with said they thought the agency ensured that people received safe personal care. Staff had been trained in safeguarding (protecting people from abuse) and staff understood their responsibilities in this area.

Risk assessments were not fully detailed to assist staff are to support people safely.

We saw that medicines were supplied but more evidence was needed to ensure they were given safely and on time, to protect people’s health needs.

Staff had not always been safety recruited to ensure they were appropriate to supply personal care to people.

Staff had training to ensure they had the skills and knowledge to be able to meet people's needs.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choice about how they lived their lives.

Staff had awareness of people's health care needs so they were in a position to refer to health care professionals if needed.

People and their relatives we spoke with told us that staff were friendly, kind, positive and caring.

People, or their relatives, were involved in making decisions about how personal care was to be provided.

Care plans were individual to the people using the service is to ensure that people's individual needs were met.

People or their relatives told us they would tell staff or management if they had any concerns and were confident any issues would be properly followed up.

People and their relatives were satisfied with how the agency was run by the registered manager. There were comments for improvement from staff to ensure office management staff always had a positive attitude towards them and they were not pressurised to carry out excessive shifts.

Management carried out audits and checks to ensure the agency was running properly and ensure people were provided with a quality service.

We carried out a themed inspection looking at Carewatch Leicester. The agency told us 366 people were receiving services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies, with particular regard to how people's dignity were upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, who has personal experience of using or caring for someone who uses this type of service. We used postal surveys, telephone interviews and home visit to people who use the service and to their main carers (a relative or friends) to gain views about the service.

We visited four people in their own homes as part of this review and spoke with them and their relatives about their experiences of the care, treatment and support received. We spoke with sixteen people who received a service from the agency, over the telephone. We spoke with three managers, two senior care workers and two care workers during our visit.

People understood their care, treatment and support choices available to them. They felt their views and experiences were taken into account. They told us care workers recognised and respected their privacy dignity and independence. People felt supported to make decisions and care workers listened to them. Care workers told us they understood the aspects of the safeguarding processes that were relevant to them and people that used the service told us they felt safe. The agency provided different ways for people to give formal and informal feedback about the service; and monitored the quality of service that people received.

People told us, “Some days I can do things myself more than other days – they support me and know then to just keep an eye on me.” “My relative’s speech is poor but over the years the regular care workers somehow communicate without the need for speech and she has built up a rapport and trust with them.”

We used a number of different methods to help us understand the experiences of people who used the service. We received 38 completed questionnaires, we spoke to eight people who used the service, or their relatives, by telephone and we met six other people when we accompanied a Carewatch (Leicester) member of staff as they conducted spot checks on the quality of the service.

Written consent was secured before providing care and support to people. Staff ensured they offered choices and followed people’s wishes when providing support to them.

Overall, people told us that they were satisfied with the service they received. Staff usually arrived on time and provided people with the support they needed.

Arrangements for supporting people with medication were reliable. Staff participated in regular training to ensure their skills and knowledge in relation to medicines were up to date.

A formal recruitment process was followed and appropriate checks taken up to ensure that staff were suitable and appropriately skilled.

There were arrangements in place to help monitor the quality of the service. When comments or concerns were received appropriate action was taken in response to these.