Aspirations Support Bristol

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

Safeguarding systems, processes and practices were effective to help ensure people were protected from the risk of abuse and neglect. The service had a balanced and proportionate approach to risk that empowered people and respected the choices they made about their care. Safe recruitment practices helped ensure all staff were suitably experienced, competent, and able to carry out their role. There were appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that was person centred. Staff received training that was relevant to their roles and responsibilities. They felt they were supported by the management team and colleagues. This included team meetings, supervision, and support to personally develop.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Feedback from people and relatives confirmed staff provided care and support that protected people and that they were in good hands. In addition, they felt confident to report any concerns around safety and well-being, they knew who to speak with and felt they were listened to. We were provided with examples where the service had taken appropriate actions when concerns had been raised and the local authority safeguarding team had been informed and internal investigations had taken place to help improve practice and prevent recurrence.

Staff took every precaution to help keep people safe from unnecessary harm. They were kind and ensured people were happy and felt safe. They encouraged people to make choices to reduce risks and stay safe, whilst respecting people's rights to make their own decisions. Staff told us immediate action would be taken to keep people safe should any abuse or neglect be suspected. This included working in partnership with other health and social care professionals. Comments included, “I frequently deal with potential safeguarding alerts, I encourage staff I supervise to report and record all areas of concern. It is my responsibility to raise a safeguarding concern with the relevant authorities” and “Any incident that results in a service user being in danger or that there is suspected abuse, the relevant authorities will be notified for an investigation. Transparency is key and the service user's safety and dignity is a priority.”

Staff understood what constituted abuse and the processes to follow to safeguard people in their care. Policies and procedures were available, and staff had attended safeguarding training updates to refresh their knowledge and understanding. The management team and staff recognised their responsibilities and duty of care to raise safeguarding concerns when they suspected an incident or event that may constitute abuse. They notified the relevant agencies including the local authority, CQC and the police. People’s capacity to make decisions was assessed. Assessments were discussed with relevant parties and outcomes recorded. The management team had submitted appropriate Deprivation of Liberty Safeguard applications for people. Staff understood the principles of the Mental Capacity Act 2005 and had received training to ensure they knew how to apply these in practice.

Feedback confirmed people were supported to take risks balanced on their safety and their health care needs. People's capacity had been considered when such choices had been made and their right to take informed risks was respected. We saw good examples where extensive work, re-evaluation, monitoring and support had enabled people to be as independent as possible, whilst respecting there may be a degree of risk. This included, promoting life skills, attending appointments, managing medicines and finances, and exploring services within the local community. The registered manager and staff provided examples of a positive, person-centred approach to the management of risk and this was reflected in individual’s achievements.

Staff and leaders knew and understood the risks to people in their care. Staff told us risk assessments contained up to date information to support people safely and effectively. They had a good level of understanding when identifying potential risks, managing actual risks, and keeping these under review. Staff understood their responsibilities for reporting accidents, incidents, or concerns. Comments from staff included, “We encourage the person to take control of their life as much as possible, this helps them to develop self-confidence and decision-making skills in their home and community”, “When supporting people to take positive risks, I sit with the service user, and we research all relevant information for them to make an informed decision. We then break these risks down into bite size achievable steps towards their goal” and, “Staff will discuss the choice the service user is making and ensure they have all necessary information for them to make an informed decision. They are encouraged and reminded of their achievements every step of the way so that they know and remember they are supported towards their goal.” Staff had identified when certain behaviours from people could impact on their safety and that of other people. They considered what triggers may exacerbate certain behaviours so these could be avoided wherever possible, for example loud noises, shouting, pain, and distress. Where this had not been possible, staff knew how to support people to de-escalate the situation. Staff had the knowledge and skills to protect people safely without being restrictive. This particularly related to supporting people with behaviours that they were unable to control at times.

Processes and systems such as handovers, care record reviews, service user and relative meetings and staff meetings helped ensure risks continued to be managed safely and were effective in enhancing people’s lives. In addition, the service worked alongside families, significant others and health and social care professionals to help provide a holistic approach to risk management. Written accident and incident documentation was comprehensive. There was evidence of learning from incidents and changes were implemented. Monthly audits helped staff identify trends to avoid further recurrences.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Systems and processes helped ensure training and supervisions were up to date and supported best practice. Recruitment was seen as an essential part of keeping people safe whilst ensuring they were cared and supported by staff of good character. Safe recruitment procedures were followed. Pre-employment checks had been completed and written references were validated. Disclosure and Barring Service (DBS) checks had been carried out for all staff. A DBS check allows employers to check whether the applicant has had any past convictions that may prevent them from working with vulnerable people.

Staff confirmed there were enough staff available to meet people’s needs. This would vary depending on people’s planned activities and in response to people’s changing needs. This included when people became unwell. Comments included, “I have 2 service users that require 2 staff, specifically when accessing the community to ensure their safety, staff safety and members of the public. Regular team meetings ensure that staff can support each other and can discuss strategies within a safe environment enabling the team to have consistent approaches to the individual” and “Assigning 2 staff to support a service user is based on their needs. If there is an emergency where another staff member is required, either the on-call officer will arrive to assist, or the team leader will be notified and redeployed." The management team ensured there was a suitable skill mix and experience during each shift. Staff were equipped with the necessary skills and knowledge to meet people’s physical and psychological needs. People were supported by staff who felt confident and competent to assist and care for people. Staff confirmed the training they received was effective. Comments included, “Our Induction process has evolved significantly over the years, staff receive a week of training, induction and team leaders also have time to discuss the needs of our service users prior to staff supporting them” and “The training and shadowing covered the core knowledge needed to be prepared to support vulnerable adults. I believe I have been provided with the tools to be effective in my role, I am encouraged to speak with the available on call officer if I am unsure of anything or need any help.” Individual supervisions supported staff to discuss what was going well and where things could improve. They discussed people they cared for and any professional development and training they would like to explore.

Feedback from people confirmed there were enough staff to support individuals and consistent staff were deployed wherever possible to ensure continuity of care. Relatives were not aware of the induction and training staff received but agreed they seemed competent. One relative remarked there had been an increase in new staff and that this had settled down. They told us, “The new team leader seems to be very efficient and happy to be contacted if I needed to speak with them.” Another relative stated, “Aspirations try their best and we’ve seen them trying to help support my relative with continuity of staff. As a family, having a rapport with staff is important, so by having a familiar routine with familiar faces is helpful. One staff member is brilliant at creating a bond with all service users, they give 110 percent, and you can really see that.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.