Aspire PC Limited is a domiciliary care agency registered to provide personal care for people living in their own homes. At the time of the inspection the agency was supporting 5 people who required personal care. We visited those people in their own homes. At the visits people were supported by staff from the agency at their request. We were able to speak with three of those staff during the visits. On one of the visits we also spoke with a relative of a person using the service.
At the time of this inspection the service employed 28 staff who supported people. Not all those staff provided personal care to people. We telephoned 23 of those staff and were able to speak with six of them to obtain their views and experience of working for this agency.
We told the provider two days before our inspection that we would be visiting the service. We did this because the registered manager is sometimes out of the office and we needed to be sure that they would be available.
There was a manager at the service who was registered with CQC. 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 service was last inspected on 16 May 2013 and was meeting the requirements of the regulations we checked at that time. This is the first rated inspection of the agency.
There was a strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The vision of the service was shared by the management team and staff. Staff and people who used the service told us that they thought the service was well led.
Staff told us they worked as part of a team, that Aspire was a good place to work and staff were very committed to providing care that was centred on people's individual needs.
People had confidence in the service and felt safe and secure when receiving support. Staff had a good understanding of what to do if they saw or suspected abuse or if an allegation was made to them.
There was sufficient staff to provide a regular team of care staff for people, but improvements were required with the recruitment of those staff so that all the required information was available, to demonstrate they were suitable staff to be employed.
Safe systems were not in place to manage people’s medicines.
Staff had received some training to carry out their role, so that people received effective care, but systems and processes were not established to demonstrate staff received all the required training and that this was updated on a regular basis to keep their knowledge and skills up to date. Staff received regular supervision and an appraisal system was in the process of being developed.
Care records had been reviewed but did not always reflect the care delivered to people. Risks to the health, safety or wellbeing of people who used the service were assessed and action was taken to minimise those risks, but we found not all risks with sufficient information to minimise those risks were identified on the risk assessment.
There were quality assurance systems in place to monitor the quality of the service provided, but these required improvement to ensure the service met all regulations.
People told us the service provided good care and support. They told us they felt safe, the staff were caring, kind and respected their choices and decisions. Staff were familiar with people’s individual needs and were able to describe how they maintained people’s privacy and dignity.
Staff sought people’s consent to care and treatment.
People were supported with their health and dietary needs, where this was part of their plan of care or in an emergency.
People and relatives told us when they raised any issues with staff and managers, their concerns were listened to.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.