4 February 2019
During a routine inspection
There was a registered manager in post. 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 2008 and associated Regulations about how the service is run. The registered manager was also one of the providers and had founded the company in 2013.
Not everyone using the service received the regulated activity ‘personal care’. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care such as help with tasks relating to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People who used the service and their relatives were extremely positive about the caring nature of staff and the responsiveness and reliability of the service. Everyone we spoke to, without exception, told us how the service excelled in delivering a service that met their individual needs. One person told us, "They’re excellent, absolutely excellent, couldn’t ask for better. I’ve never met nicer, more caring people who go beyond the call of duty. They’re always cheerful, happy, always willing to do more. They’re very special people.”
Reliability was a key factor in people rating this service so highly. People told us they had a small team of care staff and that this was extremely important to feeling safe and well cared for. The registered manager and other senior staff were all involved in providing hands-on care and people we spoke with knew them by name. Staff and customers were carefully matched by considering things such as people's personality, likes, dislikes, hobbies and interests. The service ensured a small and consistent team worked with each person and it was evident that both staff and people using the service benefitted from this approach.
Staff were highly motivated and took pride in their work. The values and culture of the service were exemplified by all the staff who worked in the service. People using the service used the term "go the extra mile" frequently to describe the staff. Staff members felt they were a highly valued part of the service and very much involved in feedback and decision making. Without exception staff told us they were proud and happy to work for Aspire.
Staff recruitment was robust to ensure that staff had the right attributes, skills and experience. A well-structured staff training and development programme resulted in a professional and highly-skilled workforce. In depth induction training was provided upon commencing employment. Ongoing refresher training was also provided and this was regularly updated to meet the changing needs of the people who used the service. A training and recruitment officer had been employed since our last inspection. Staff received high levels of support to enable them to provide outstanding care including regular supervision, team meetings and appraisals.
The provider had systems in place to ensure that people were protected from the risk of harm or abuse. There were policies and procedures in place to guide staff in relation to safeguarding. Risks to people were assessed and minimised by careful care planning. People received their medicines as prescribed and clear accurate records were kept.
The agency specialised in providing end of life care for people wishing to return home from hospital. This usually started with only 24 hours notice and was fulfilled by a team of very skilled and experienced staff.
All staff were provided with a phone. These were used to scan into calls and an alert was sent to the office staff, including out of hours on call, if the carer had not logged in 15 minutes after call was due to start. A system known as ‘Quikplan’ was installed on the phones and this gave basic details of the person, access to their home, the colleague who would be attending the call, and the person’s care needs. This had a very important feature of allowing the member of staff to alert others to any changes, for example changes to medication.
The care records we looked at showed that people were involved in decisions about their care and support. The care records contained good information about the support people required and were written in a person-centred style. Calls were carefully monitored by office staff and people were alerted if staff were going to be late. Three monthly reviews and annual full service reviews were recorded in people’s care files.
There was an open culture that was driven by a visible management team. The providers spoke with passion about the service, what they had accomplished and how they wished to improve the existing high standards of care in the future. The service was exceptionally well-led and had excellent links with healthcare professionals. There was a strong emphasis on continually striving to improve the quality and safety of the service and ensure that people were receiving excellent outcomes.