Aroma Care - Cotswold

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

Good: This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received care and support which was focussed on their individual needs. People’s records reflected their choices and preferences which helped staff deliver the care and support people wanted. For example, we observed one person’s care plan included specific communication prompts to use when the person refused support with personal care or eating and drinking, this was unique to the person and met their needs. We observed another person’s care plan which detailed a preference they had to remain in bed, and what support was sought to enable this person to live the way they chose while minimising the risk of skin breakdown. The person had capacity and was able to consent to having bed rails and we saw appropriate risk assessments were in place. The manager undertook regular checks with people, and others involved in their care, to ask for their feedback about their care and support and whether this was continuing to meet their needs and made changes when this was required.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Although we found staff had specific training to meet the diverse needs of people using the service and we saw evidence staff compatibility was considered as part of the pre-assessment protocol, we received mixed feedback from people using the service and partner agencies. Some people told us they always saw the same staff, while others told us they were always different. The manager told us, “We try to keep people on the same runs (routes), and we know which staff get on best with which people.” One person told us, “I don’t have regular carers but all of them who come are all very good and they are all so kind.” However, partnership agencies told us they experienced poor interactions with the service and had received multiple complaints from people about the consistency of staff, staff being late for calls and staff knowledge. While we received multiple complaints from people who told us they were unaware of who the manager was or how to contact them, we saw contradictory evidence of the manager calling people and speaking to either the person themselves or their relative. It did not become evident during the inspection why we found positive evidence but received negative feedback.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Although we found staff had specific training to meet the diverse needs of people using the service and we saw evidence staff compatibility was considered as part of the pre-assessment protocol, we received mixed feedback from people using the service and partner agencies. Some people told us they always saw the same staff, while others told us they were always different. The manager told us, “We try to keep people on the same runs (routes), and we know which staff get on best with which people.” One person told us, “I don’t have regular carers but all of them who come are all very good and they are all so kind.” However, partnership agencies told us they experienced poor interactions with the service and had received multiple complaints from people about the consistency of staff, staff being late for calls and staff knowledge. While we received multiple complaints from people who told us they were unaware of who the manager was or how to contact them, we saw contradictory evidence of the manager calling people and speaking to either the person themselves or their relative. It did not become evident during the inspection why we found positive evidence but received negative feedback.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The manager had regular contact with people to check they were happy with the support provided. We saw evidence of routine calls made to people seeking their feedback on the service and people sharing not only good practice but also sharing complaints, which indicated people felt comfortable sharing negative reviews. People we spoke to confirmed they were regularly contacted for feedback and staff had spot checks by the manager. One person told us, “The manager rings me regularly to see if I am happy with everything and I always say the same, ‘yes’.” People and relatives were given information and supported to give feedback, raise concerns or make a complaint. Staff listened to them and took action to make changes when these were needed. A relative told us, “I have regular contact with the manager, she rings regularly making sure that everything is ok, and they even do spot checks on the carers from time to time." The manager described the action they had taken to address an issue raised by a visiting professional. It was reported a staff member was absent during a care call. The investigation found the person had asked the staff to leave while they ate lunch, so the staff member went to their car and thereby missed seeing the visiting professional. This led to the manager communicating with all staff about the importance of staying in or within sight of the property during the entire duration of the care call. People were given the number for the office when they started using the service and a handbook detailing the complaints policy.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

The provider had a service user handbook which was distributed to people when they started using the service which detailed the out of hours arrangements. The service did have an out of hours number. However, some people we spoke to told us they could not get through to anyone out of hours and found communication difficult. Staff we spoke to were inconsistent in their knowledge of what barrier’s people faced in relation to care and support and were not always able to explain how to escalate concerns to managers.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The care plans we reviewed showed how the service had considered people’s protected characteristics and made reasonable adjustments to support equity in experience and outcomes. For example, one person’s care plan showed a person had a physical disability and required mobility aids to improve their experience. People did not have any concerns about discrimination within the service. Staff told us they treated people equally. One staff member told us, “I try as much as I can to treat everyone the same, as soon as I think about having a favourite I am compromised.” Risks to people becoming isolated were understood by staff and managers. The manager told us staff were encouraged to sit and talk to people to reduce isolation and loneliness. The manager told us, “We always highlight person centred care. We do our training and develop staff to focus on what's important to the person. If you have a 74-year-old from London who likes a bit of banter, we encourage this. Staff are discouraged from being task focussed.” We found although staff had received training on equality and discrimination, there could be enhancements to how staff and managers could advocate on people’s behalf to help tackle discrimination, such as creating more detailed care plans around specific conditions and strengthening ties with people and relatives who felt they were not listened to.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

At the time of our inspection the service was not supporting anyone with end-of-life care. People and relatives, we spoke to did not want to discuss this topic. One relative told us the service used to provide support for both parents, before one of them passed away but did not give us specific feedback on the end-of-life care provided. The relative told us “This is a very good service.” We saw the service had a company branded leaflet on end-of-life care and the manager told us staff are currently being trained under a nationally recognised training programme. The manager told us, “We offer advance care plans, but some people refuse this. We give people leaflets for this. We capture everybody's wishes. We need to be making sure we are giving proper care, so we focus on good communication. Bonds with family are our main objective.” The manager told us in the larger branches of the organisation they have a memory tree where people who have passed away in the Cotswolds area are included on the tree.