Aurora Home Care Ltd

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This key question was previously rated good. The key question is now rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 did not consistently ensure people’s needs were assessed and reviewed in a thorough and person-centred way. Care plans were sometimes incomplete and lacked essential, up-to-date detail about risks and individual preferences.

Records relied heavily on local authority initial assessment information rather than provider-led assessments. Reviews had not meaningfully built on these initial assessments. The electronic care records system did not therefore have sufficient up to date information about people’s needs.

Staff could access basic information via the care records system and experienced staff did understand people’s needs well. One external professional said, “The staff are really good at knowing their clients and being able to understand their needs, if they do not understand something on the paperwork in which they receive they will always contact us and query something or ask for more details if this is required.”

The service did not fully embed evidence-based practices into care delivery. While some training was in place, gaps were identified in key areas such as diabetes awareness and learning disability awareness training. Moving and handling training had been delivered but the registered manager recognised this needed improving, with more face-to-face sessions. One staff member said, “I would benefit more with some hands-on training.” This was a consistent theme amongst the staff team.

The registered manager and staff did not have a full understanding of Right Support, Right Care, Right Culture. This is guidance regarding how all CQC-registered services supporting people with a learning disability or autism should ensure how their services are run, and people are supported.

Although staff demonstrated good practical knowledge, care planning and governance systems were not developed enough to assure safe and effective care. The registered manager acknowledged these shortfalls and was seeking additional resources to address them. The provider had implemented an electronic records system that had a range of issues when we reviewed it. The registered manager was responsive to our feedback and signposting to areas of good practice.

The provider made sure staff worked collaboratively to deliver care, and there were positive examples of teamwork. People consistently praised staff for their reliability and communication. Staff liaised with district nurses and care managers when needed, and there was evidence of shadowing and induction processes for new staff. One external professional told us, “The staff team has been established for a couple of years and is relatively small. Staff members know the individuals extremely well and have developed strong, trusting relationships.”

The registered manager ensured supervisions had occurred more regularly recently, and spot checks were being carried out to provide staff with additional support and guidance. More formal governance structures and audit systems were still in development, which limited the provider’s ability to monitor and improve joint working with external professionals. Despite this, staff were committed to working together to meet people’s needs.

The provider did not consistently document how it supported people to achieve healthier lifestyles. While staff helped with meal preparation and hydration, care plans lacked detail about nutrition, physical activity, and individual goals, particularly aspirational health goals and objectives. There were some missed opportunities to include more positive risk-taking and enablement goals. However, people, relatives and external professionals confirmed that people did enjoy a range of healthier approaches and had a good quality of life.

Some daily care records were transactional rather than supporting and enabling people to pursue their aspirations.

The absence of comprehensive assessments and reviews meant the service could not always demonstrate a proactive approach to promoting wellbeing (although some staff clearly helped people enjoy some positive quality of life experiences, such as meals out, shopping and holidays). The registered manager was responsive to feedback and signposting about, for example, improving access to best practice around diet and healthy living for people who used the service.

Systems for monitoring outcomes were underdeveloped. The provider had begun building a quality assurance platform, but at the time of inspection, there were no effective audit structures in place. Care records were inconsistent, and governance arrangements were not embedded. Daily notes varied in quality, with some lacking person-centred detail. While the registered manager was committed to improvement, progress was at an early stage and had not yet translated into measurable outcomes for people. This was after external input previously about the need to improve governance. The provider needed to significantly improve this area to be able to understand and demonstrate how they were helping people to achieve good health and wellbeing outcomes. The registered manager recognised this and committed to making prompt improvements.

Feedback from external professionals recognised positive impacts for people using the service, thanks to staff support. For instance, one told us, “Clients appear content and settled, with their needs consistently met.”

The provider ensured people’s consent was sought and respected. There were no restrictive practices and staff were aware of processes for managing risks and safeguarding. People told us they felt involved in decisions about their care, and relatives and others were consulted where appropriate. Staff treated people with dignity and respect, and there were no concerns about lack of choice. They ensured people’s home was their own and they were in control. However, care plans did not always record consent clearly. The provider had started planning improvements in this area, including more training on the Mental Capacity Act, but this was not yet fully embedded.