Archived: Aroma Care Northampton

Aroma Care is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community. At the time of the inspection there were 115 people receiving personal care and support.

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.

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

Quality monitoring checks lacked details about the areas of concern and there was no action plan in place to monitor planned improvements . . We continued to receive concerns from some people and relatives that communication was not always effective. Following our feedback to the registered manager they informed us they had a meeting with staff and put plans in place to improve communication with people.

Improvements had been made to accident and incident reporting so action could be taken to promote people’s safety. However, systems in place to learn lessons when things went wrong needed to be strengthened.

Improvements had been made to the systems and processes in place to seek people's views. We were unable to find a record of any actions taken as a result of people’s feedback. The provider had made improvements to how they responded to complaints. People we spoke with were happy with how their complaints or concerns had been dealt with.

Improvements had been made to the risk management systems to ensure staff worked safely with people and understood what risks may be present in their lives. We found the systems and processes for administering people’s medicines had been improved. Staff administered people’s medicines safely and quality checks of medicines were undertaken.

The provider had made improvements to their recruitment procedures to ensure people were protected from staff that may not be suitable to support them. Improvements had been made to the timings and consistency of people’s calls to ensure they received their care when they needed it from staff that knew them.

Infection control measures were robustly followed, and staff had access to sufficient PPE.

People received safe care and support from staff. Staff understood safeguarding procedures and were confident in reporting any concerns.

People were consulted about their care before the services were provided. Staff received appropriate training for their roles and people felt staff had good knowledge and skills. People’s care plans included all information needed to support people safely and in accordance with their wishes and preferences. Staff had received an induction into their role and the management team monitored this to ensure training remained up to date.

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 told us they were treated with kindness and compassion and their privacy was respected. They told us they were fully involved in the care planning and reviews of their care.

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 Improvement (published 26 January 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Aroma Care is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community. At the time of the inspection there were 33 people receiving personal care and support.

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.

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

The provider continued to fail to have sufficient systems and oversight to assess, monitor and mitigate the risks relating to the health, safety and welfare of people. Care plans and risk assessments lacked essential information so that staff could provide appropriate care and support safely.

Systems in place to ensure people received their medicines as prescribed needed to be strengthened to ensure they were more robust and effective.

There was a high level of dissatisfaction in relation to people’s care calls that included people experiencing missed and late calls, a lack of consistency of staff and staff not staying for the allocated time of the care call.

Systems and processes to engage with people were not always effective at identifying the level of dissatisfaction we received from people and relatives about the times and length of their care calls.

People expressed frustration about the poor communication systems in place, the lack of response to complaints and the attitudes of some staff. Some people did not feel they received person centred care.

The systems in place to assess, monitor and improve people's quality and safety of care needed to be strengthened to ensure people received the care they needed, at the time they required so their needs could be fully met.

There were systems and processes in place to safeguard people from potential harm. Staff completed training about safeguarding people from harm; we were not able to assess staff understanding and knowledge around safeguarding as we were only able to speak with one staff member.

The provider had improved their recruitment practices to ensure people employed were suitable to work at the service and support people.

Effective systems were in place to control and prevent the spread of infection. People told us that staff always wore PPE when carrying out personal care.

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 Requires Improvement (30 April 2021)

At this inspection enough improvement had not been made/sustained and the provider was still in breach of regulations

Why we inspected:

The inspection was prompted in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two continued breaches in relation to safe care and treatment and good governance and a further breach of regulation in relation to staffing.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Aroma Care Northampton is a domiciliary care agency providing personal care to people in their own homes. At the time of the inspection, the service was supporting 41 people.

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.

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

Risk assessments were not always in place to provide information and guidance for staff on the risks associated with people's care and how to mitigate those risks. There was no system in place to review people’s care plans, to ensure the information recorded was reflective of people’s current needs including identified risks.

People’s care plans and risk assessments were not updated following accidents or incidents.

Medication Administration Records (MAR) did not evidence that people had received their medicines as prescribed. The system in place to audit medicines management was not effective and did not identify the concerns found during the inspection.

There was no system in place to monitor staff call schedules to ensure people received the duration of their calls.

People told us they received support from regular carers who were recruited safely. Staff had received training for infection control and understood the personal protective equipment (PPE) requirements when supporting people. People told us staff wore the appropriate PPE.

Staff understood how to recognise and report abuse. People and their relatives told us they felt safe when being supported by staff.

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. However, where a person had been identified as lacking capacity, the provider had not completed mental capacity assessments or best interest discussions as required.

People's needs were assessed before they started using the service to ensure these could be met. However, not all information from the assessments was used to develop care plans and risk assessments to support people’s needs. Care plans were not always person centred.

People and their relatives spoke positively about the care and support they received from staff and staff demonstrated they knew people well. Staff completed training relevant for their role which included safeguarding, moving and handling and medication.

The management team and staff worked with health and social care professionals to improve outcomes for people. People told us that they received regular contact from the office and felt confident to raise any concerns or issues

Staff team meetings were not taking place due to the COVID-19 pandemic however, staff received supervision meetings and told us that they had good communication with the manager and other staff members.

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

Rating at last inspection

This service was registered with us on 11 August 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staff recruitment and management oversight. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. 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.

We have identified breaches in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) 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 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.