Background to this inspection
Updated
3 October 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The team consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager in post who was in the process of registering with the Care Quality Commission. This means that they (once registered) and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 4 September 2020, we visited the office location on this date. Inspection activity ended on 10 September 2020. This is the date we finalised our review of documents requested from the service and completed our telephone conversations with people who use the service, their relatives and staff.
What we did before the inspection
Before the inspection, we reviewed information we had received about the service. This included details about incidents the provider must let us know about, such as safeguarding events and statutory notifications sent by the provider. A notification is information about important events which the provider is required to tell us by law, like a death or a serious injury. We sought feedback about the service from the local authority and other professionals involved with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with the manager and the care co-ordinator. We looked at records in relation to people who used the service including four care plans and multiple medication records.
We looked at records relating to recruitment, training and systems for monitoring the quality of the service provided.
Details are in the Key Questions below.
After the inspection
Due to the risks of Covid-19, we did not make home visits to people who used the service, instead, we sought feedback from people and their relatives over the phone. We spoke with two people who used the service and two relatives. We also spoke with two members of staff. We requested further documents from the service and continued to seek clarification from the manager to validate the evidence we found.
Updated
3 October 2020
About the service
Aroma Care is a domiciliary care at home service. 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 there were 29 people using the service all of whom received assistance with personal care.
People's experience of using this service and what we found
Staff had not always been recruited in a safe way and pre-employment safety checks had not been completed before staff started supporting people in their own homes.
Risk assessments were not always in place or adequate to minimise risks to people. We have made a recommendation about assessing risks of Covid -19 when assessing infection control practises.
Care plans were not consistent and did not contain accurate information about people's health care needs and requirements. Care records lacked person centred detail and did not always detail people’s preferred routines and preferences.
Not all staff had received training in relation to the Mental Capacity Act 1998. This meant we could not be fully assured that people were supported to have maximum choice and control of their lives and that staff always supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
Some assurance and auditing processes had not been implemented, meaning the quality and safety of the service being provided was not always being effectively assessed and monitored.
The service had not ensured that all staff had received the necessary training they needed before commencing their roles.
At the time of the inspection, some of our concerns were in the process of being addressed by the registered provider and assurances had been provided that improvements would be made.
People using the service and their relatives told us they were happy with the care and support provided and spoke positively of the staff. People told us they were cared for by the same members of staff who were familiar to them and knew their needs and preferences. Relatives told us they felt staff provided safe care to their loved one.
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 1 April 2019 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about staff recruitment and training. 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 and Well-led sections of this full report. You can also see what action we have asked the provider to take at the end of this full report.
The registered provider has acted to mitigate the risks and address the concerns we found.
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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to Regulation 11 (Consent), Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 19 (Fit and proper persons employed).
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.