Aspire Care Support Services is a domiciliary care service that provides support for approximately 90 people in their homes. We previously inspected the service on 20 June 2016 and rated the service as good in all areas. At this inspection we found that the service remained good and was outstanding in the 'caring' domain.

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. The

We visited the service on 20 June 2016. We gave short notice to the manager to ensure that she would be available for the inspection. Aspire Care Support Services provides care and support to people living in their own homes across the Wirral. This included support for 11 people with disabilities who had their own flats within a supported living service, and end of life care for people being discharged from hospital. At the time of our visit, the agency was providing support for 80 people, and 47 support staff were employed.

The service had a registered 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 2008 and associated Regulations about how the service is run.

The response from people who spoke with the expert by experience was very positive and one person told the expert by experience that Aspire was a “five star service”.

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.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults. We found that good recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. Staff received regular training to enable them to work safely and effectively.

This was the first visit made to Aspire since its registration with us in May 2013. We spoke to five people who used the service and two agencies that commissioned their services. Comments included:

"They are always on time or ahead of time; they always turn up and go the extra mile"

"I am able to contribute to my care and it is based on me as a person"

"They are fantastic"

"I feel safe and at ease with the staff"

"They are knowledgeable about my needs"

"They always let us know what is happening"

"The continuity of care is very good; they have picked up on needs very quickly"

"I have every confidence in them"

"They are an excellent agency, one of the best and are our preferred provider"

"They go over and above what is needed with our service users"

"We can rely on them to provide a care package at short notice and do it well"

"We are very happy with this provider, they are highly professional"

This visit found that the service fully promoted the health and wellbeing of the people they supported and protected them from harm. People who used the service were supported by staff who were supported in their role. People benefitted from receiving support from an agency that monitored its performance on a regular basis.

This visit found that the recruitment process was not fully complete. While essential checks were made on the character of staff, no health declarations had been received during recruitment. This is raised as a minor compliance action in this report.