We carried out a review of the data available to us about Aspire in the Community - The Gate on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Aspire in the Community - The Gate, you can give feedback on this service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service received planned and co-ordinated person centred support that is appropriate and inclusive for them.
People’s experience of using this service:
The service met the characteristics of a good service in all the areas we reviewed.
The outcomes for people using the service reflected the principals and values of Registering the Right Support in the following ways. The service promoted choice, control and independence. Each person had a bespoke living environment complete with bedroom, individual living space and cooking facilities. This helped ensure the service was very person centred. People had maximum control over all aspects of daily life. This included their routines, activities and meals. People’s support focused on increasing their opportunities and providing them with skills to become more independent.
Risks to people’s health and safety were assessed and for the most part appropriate risk assessment documents were in place which were subject to regular review. People received their medicines safely and as prescribed, with people encouraged to be involved in the management of their own medicines.
There were enough staff deployed to ensure people’s needs were met. Staff were recruited safely and only worked with people following training and if they were deemed competent.
Staff were kind and compassionate and treated people well. People were listened to, taking into account their individual methods of communication. People were involved in care and support planning.
Whilst a registered manager was not in place, the nominated individual was working within the service on a daily basis. They had good oversight of the service and ensured it operated to a high standard.
Rating at last inspection: The service was last inspected on 30 August 2016 and rated Good. At this inspection we found the service had maintained its rating of Good.
Why we inspected: This was a planned inspection which took place to re-assess the quality of the service provided as we had not visited since 2016.
Aspire Respite Support Services is a care home registered to provide care for up to three younger adults who have a diagnosis of a learning disability and/or mental health. At the time of this inspection two beds were being used for longer term placements and one bed was used as a respite service which six people used for 42 to 62 nights each year. The accommodation consisted of three apartments each with their own facilities, including a well equipped kitchen and lounge area, separate bedroom and individual bathing facilities. People who used the service had access to local community facilities such as shops, pubs and churches.
The service did not have a registered manager. However, the service was actively looking to appoint a manager and while this process is taking place the nominated individual who was one of the managing directors for the organisation was acting as the manager. 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.
Some people we spoke with had limited verbal communication. However, they very clearly indicated they felt safe and were happy living in the home, liked the staff and did the activities they liked to do. Picture cards were used for some people who used the respite bed for holiday stays to help them express their thoughts and wishes.
There was a strong person centred and caring culture within the service. (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.
There were enough skilled and experienced staff and there was a programme of training, supervision and appraisal to support staff to meet people’s needs. Procedures in relation to
recruitment and retention of staff were robust and ensured only suitable people were employed in the service.
The acting manager was aware of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). There were policies and procedures in place and key staff had been trained. This helped to make sure people were safeguarded from excessive or unnecessary restrictions being place on them.
Medications procedures were in place including protocols for the use of ‘as and when required’ (PRN) medications. Staff had received training in medication management and medication was audited in line with the provider’s procedures. There was good guidance for staff regarding how people expressed pain or discomfort, so they could respond appropriately and seek input from health care professionals, if necessary. People had access to a good range of health care services and staff actively advocated for people if they felt health care services were not as responsive as they should be.
People were encouraged to make decisions about meals, and were supported to go shopping and be involved in menu planning. We saw people were involved and consulted about all aspects of their care and support, where they were able, including suggestions for activities.
We observed good interactions between staff and people who used the service. People were happy to discuss the day’s events and one person told us about their likes and interests. One person told us how they liked to cook and invited staff to join them for a meal.
People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it.
They had systems in place to assess and monitor the quality of the service and to continually review safeguarding concerns, accidents and incidents. Where action plans were in place to make improvements, these were monitored to make sure they were delivered. We saw copies of reports produced by the acting manager and by an external assessor. The reports included any actions required and these were checked each month to determine progress.
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe, effective, caring, responsive and well led?
Below is a summary of what we found.
Is the service safe?
There were risk assessments in place where required for people using the service in relation to their support and care provision. People were not put at unnecessary risk, but had choice and remained in control of their own decisions. This meant that people's independence was promoted and they were not restricted from engaging in and accessing the wider community.
Safeguarding procedures were robust and staff understood how to safeguard the people they supported.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This means risks to people are reviewed and monitored to minimise any further risks and helps the service to continually improve.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, but no applications had needed to be submitted. This meant that people would be safeguarded as required.
Policies and procedures were in place to make sure that unsafe practice is identified and people are protected.
A family member explained they found it difficult to trust services, because of previous experiences, but at Aspire they have no reason to believe their relative wasn't safe. They explained their relative was happy to be left at the service, showed no signs of distress when they returned and didn't return home with unexplained bruising.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
Is the service effective?
People's health and care needs were assessed with them and they were involved in the formulation of their support plan. A family member said that their relative's support reflected their current needs.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A family member said the experience of using Aspire Respite and Support Services had been very positive. They explained how immediately the registered provider identified their relative's needs and how their relative had been supported to improve their daily living skills in regard to the dining experience. They described how staff at Aspire have understood their relative's sense of humour and how they listen and react to that. They said, 'all in all I've been very impressed.'
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's preferences.
Is the service responsive?
Services were organised so that they met people's needs. People completed a range of activities in and outside the service regularly and were assisted to access the community and maintain relationships with family members.
The service had systems in place to deal with people's concerns if necessary.
Is the service well-led?
The leadership, management and governance of the organisation was focused on the delivery of person-centred care. The service worked well with other agencies and services to make sure people received their care in a joined up way.
Discussions with staff told us they were clear about their roles and responsibilities. Discussions on best practice, improved ways of working and incident reviews were common throughout formal team meetings and informal discussions.
The service had a quality assurance system in place and records seen by us showed that identified actions, in the main were addressed within reasonable timescales.
If you want to see the evidence supporting our summary please read the full report.