This assessment took place between 16 April and 17 April 2025. Aroma Care-Cotswold is a homecare service providing the regulated activity of personal care to people living in their own homes. Not everyone who used the service received the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. At the time of our inspection there were 52 people using the service, of which 48 people were receiving the regulated activity of personal care. The service demonstrated strong person-centred leadership with a focus on delivering high quality care for people using the service, employee wellbeing and high-performance standards. The management team worked together with their staff team to embed good practice across the service. People received safe care and support from staff who knew them well. Medicines were managed safely. Staff received appropriate training and support relevant to their roles. Risks to people had been assessed and guidance was available for staff to mitigate the risk of harm. The service was no longer in breach of regulations 17 and 18 of the regulated activity. At the time of the inspection, there was no Registered Manager in place, however an application had been sent to CQC before the inspection for the Nominated Individual to also be registered as the Registered Manager. The on-site inspection was carried out with the Service Quality Manager of the branch, who for the purposes of this report will be referred to as the manager.
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Aroma Care – Cotswold was rated Requires Improvement following a focused inspection triggered by concerns about staffing and consistency of care, with breaches found in Regulation 17 (Good Governance) and Regulation 18 (Staffing). Missed and late visits, inconsistent medicine administration timing, and ineffective governance monitoring were the principal findings, though safeguarding, infection control, and staff morale were noted as strengths.
Concerns (6)
criticalMissed or late visits: “Most people we spoke with raised concerns about missed visits, staff arriving late or not staying for the agreed care call time.”
criticalStaffing levels: “Staffing allocation had not always been operated effectively to ensure sufficient numbers of suitably qualified staff were working with people. This was a breach of regulation 18.”
criticalGovernance: “Systems had not been operated effectively to assess, monitor and improve the service being provided. This was a breach of regulation 17 (Good Governance).”
moderateMedication management: “The inconsistency of call times meant people did not always receive their medicines at the time specified on the MAR chart.”
moderateIncident learning: “The provider's systems to monitor staff 'logging in and out' of their care calls did not identify the breadth of concerns we found on inspection.”
minorComplaints handling: “Not all complaints contained enough detail to provide assurances around the investigation process.”
Strengths
· Staff had received infection control training and had access to PPE to safely manage and control the prevention of infections.
· DBS checks had been completed prior to new staff starting work at the service.
· Staff had received medicines training to ensure they were able to support people with their medicines.
· Risk assessments were in place to identify how staff should work safely with people.
· The registered manager understood their responsibilities around the duty of candour.
Quality-Statement breakdown (9)
safe: Staffing and recruitment; Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Working in partnership with othersRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood