Archived: Aspirations (Northampton)

Aspirations (Northampton) is a supported living service providing personal care to adults with learning disabilities and/or autism. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection 29 people were receiving personal care.

People lived in their own accommodation either in a house with shared communal areas or a flat or bungalow in the community. Some accommodation had a room for staff to use if 24-hour support was required.

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

The service did not have a registered manager in post and audits had not always been consistently completed or signed off as per the providers procedures. Audits that had been completed contained actions and strategies to mitigate issues found.

Not all staff had completed up to date training. The provider was in the processing of ensuring staff completed the relevant courses.

Medicine management required improvement. Not all medicine administration records were consistently signed or completed.

People were protected from harm and abuse. People and relatives told us they felt safe being supported by Aspirations (Northampton). Staff understood safeguarding procedures and incidents and accidents were recorded and investigated appropriately.

Staffing levels were safe and people were supported by a consistent staff team who knew people well. Staff had been safely recruited.

Arrangements were in place to safely manage and monitor risks associated with people’s care. Risks were assessed, recorded and strategies implemented to reduce those risks.

People were protected from infection control. Staff had adequate supplies of personal protective equipment [PPE] and knew what PPE to use in specific circumstances. Staff were involved in regular testing for COVID-19.

The provider learnt lessons through identifying trends and patterns from incidents, accidents and complaints. These lessons were then shared with staff through team meetings and supervision.

People, relatives and staff were supported to feedback on the service. Complaints received had been investigated and responded to.

People were supported to have their healthcare needs met. Referrals to external professionals were completed as needed.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were supported in homes that were personalised to them. Staff supported people to access and be part of their local community and promoted people’s independence.

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

Rating at last inspection and update

The last rating for this service was requires improvements (published 17 January 2020) and they were found to be in breach of regulation 17: Good Governance.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had been made and the provider was no longer breach of regulations.

Why we inspected

We received concerns in relation to oversight and a COVID outbreak. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aspirations (Northampton) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Aspirations (Northampton) is a supported living service providing personal care to adults with learning disabilities and/or autism.

People lived in their own accommodation either in a house with shared communal areas or a flat or bungalow in the community. Some accommodation had a room for staff to use if 24-hour support was required.

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 possible 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Following our last inspection in May 2018, the registered manager had left and there had been several changes in managers. This had impacted on the overall governance of the service and had left people vulnerable to not receiving the level of support they required.

Systems in place to quality assure and monitor the service had not been consistently maintained. Staff were not always receiving the support and training they required to effectively and safely support people.

Risks to people’s care had been assessed and detailed support plans were in place, however, some staff did not always follow or understand their responsibilities.

There was not always the staff with the right skills and abilities to support people to access the local community.

An action plan was in place to address the shortfalls identified and the provider was working with the local authority to address the issues.

People were being supported by staff who knew them well and were kind and caring. People had developed positive relationships with staff, some staff had known people for many years.

People had detailed care plans which focussed on them as individuals and gave staff the information they needed to support people in the way they preferred.

People were treated with respect and their individuality recognised. They were supported to maintain good health and nutrition and undertake activities within their homes and community.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received. Information was provided to people in an accessible format to enable them to make decisions about their care and support.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to live fulfilled lives.

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

Rating at last inspection

The last rating for this service was Good (published 10 May 2018).

Why we inspected

The inspection was prompted in part due to concerns received about the level and adequacy of the support people were receiving and the overall management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

The local commissioners had found alternative placements for three people whose needs were not being fully met at the service. We found no evidence during this inspection any other people were at risk of harm from the concerns raised.

Enforcement

We have identified a breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for 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.

We carried out an un-announced comprehensive inspection of this service in August 2017. After that inspection we received concerns in relation to an incident following which a person using the service died. We also received some other concerns from the local authority. As a result, we carried out a comprehensive inspection to look in to those concerns.

Aspirations (Northampton) provides care and support to people with learning disabilities living in ‘supported living’ settings, so that they can live in their own home 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 . At the time of inspection, 35 people were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in post, but was not available on the day of our inspection. 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.

People told us they felt safe, and staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. People had risk assessments in place to cover any risks that were present within their lives, but also enable them to be as independent as possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by their manager.

Staffing levels were adequate to meet people's current needs.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. References and security checks completed as required.

Staff attended induction training where they completed mandatory training courses and were able to shadow more experienced staff giving care. All new staff were taking part in the Care Certificate which teaches the fundamental standards within care. On-going training was offered to staff and mandatory areas of training were kept up to date.

Staff supported people with the administration of medicines, and were trained to do so.

Staff were trained in infection control, and told us they had the appropriate personal protective equipment to perform their roles safely. We saw that staff had reported any concerns they had around infection control within people’s homes to management, who had then acted appropriately.

Staff were well supported by the manager and senior team, and had one to one meet ups, spot checks and observations.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this, and people could be supported to access health appointments when necessary.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. People told us they were happy with the way that staff spoke to them, and provided their care in a respectful and dignified manner.

People were involved in their own care planning and were able to contribute to the way in which they were supported. Care planning was personalised and mentioned people’s likes and dislikes, so that staff understood their needs fully. People told us they felt in control of their care and were listened to by staff.

The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.

The people we spoke with knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed.

The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and improvements were highlighted and worked upon as required.

At the last inspection on 6 and 22 July 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People’s needs were safely met. There were sufficient numbers of staff available to meet people’s needs in a timely way. Staff had received training to provide them with the skills and knowledge they needed to provide people with safe care. Assessments were in place and appropriately acted upon to reduce and manage the risks to people’s health and welfare.

People were protected from the risks associated with the recruitment of staff by robust recruitment systems and the provision of appropriate training to all new recruits. Staff understood the importance of protecting people from abuse and avoidable harm. They were aware of the actions they needed to take to report any concerns about people’s safety or well-being.

People received support from a staff team that were caring, friendly, and responsive to people’s changing needs. They were able to demonstrate that they understood what was required of them to provide each individual with the person centred support they needed to live fulfilling lives as independently as possible. People were treated with dignity and their right to make choices about how they preferred their care to be provided was respected. People’s rights were protected.

People’s care and support took into account their individuality and their diverse needs. Their needs were assessed prior to taking up the service and their agreed care plans reflected people’s needs and preferences in relation to the care provided.

People were supported to eat a healthy diet and to have access to health services in the community to improve their health and well-being. The staff followed the advice of healthcare professionals in meeting people’s needs. Staff ensured that people that required support to manage their medicines received their medicines as prescribed.

People benefitted from a service that was appropriately managed so that they received their service in a timely and reliable way. People knew how to raise concerns and complaints and the provider had appropriate policies and procedures in place to manage such eventualities. There were also systems in place to assess and monitor the on-going quality of the service. People’s views about the quality of their service were sought and acted upon.