Archived: Aspire Specialised Supported Living Service

Updated 30 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One Inspector, a member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Aspire Specialised Supported Living Service is a supported living service. This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. However, a manager had been recruited and was going through the registration process at the time of our inspection.

Notice of inspection

We gave a short period notice of the first inspection visit because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. We gave the service 48 hours’ notice of the inspection. Subsequent visits were unannounced.

Inspection activity started on 19 April 2022 and ended on 17 May 2022.

What we did before inspection

We reviewed information we received about the service. We asked the service’s manager to send us information relating to people’s addresses, communication needs and asked the manager to gain consent from people and their relatives for us to visit or contact them. We sought feedback from professionals who work with the service.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We communicated with four people who used the service and 10 relatives about their experience of the care provided. To communicate verbally with people effectively we tailored our communication to suit people’s preferences. We also observed people’s body language.

We spoke with 11 members of staff including the senior area manager, the area manager, service manager, support leaders, support workers and professionals involved in delivering training to staff.

We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We made observations of people’s care to understand their experience.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked

Updated 30 June 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Aspire Specialised Supported Living Service is a supported living service providing personal care to 14 people at the time of the inspection. The service can support up to 15 people with learning disabilities and autism.

People’s experience of using this service and what we found

Right Support

People's independence was promoted and staff encouraged people to take control of their own care. People’s care and support needs were assessed before they started to use the service and care plans were reviewed regularly. Risks associated with people’s care were assessed to identify how their care could be provided safely. Staff supported people to achieve their goals, take part in meaningful activities and pursue their interests where staffing levels permitted. However, the service had struggled with staffing levels at various times throughout the COVID-19 pandemic and this had impacted the consistency of some people’s care. We discussed this with the leadership team who evidenced steps taken to promote recruitment and retention of staff through regularly advertising for jobs, financial incentives and a local recruitment drive.

Right care

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. People had access to health care professionals when they needed them. The provider had systems in place to support people with end of life care. Medicines were not always managed safely; records contained gaps and did not always clearly identify details on how people’s medicines should be administered. Medicines were not always stored safely.

Right culture

People received good quality care, support and treatment because staff were trained in areas related to their needs and they received regular supervision from support leaders. Feedback from relatives on the culture within the service was mixed. Some relatives felt support and care had been provided to a high standard with very good outcomes for people. However, other relatives were equally as concerned with the outcomes for people and felt this was because of a lack of continuity and motivation within people’s allocated staff teams.

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

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.