About the service: Aroma Care - Cotswold is a domiciliary care agency that provides personal care to people living in their own homes and flats in the community. The service was supporting 18 people who required personal care.

People’s experience of using this service:

¿ People told us they had established relationships with their regular care workers and were satisfied with the care they received from these care workers.

¿ Improvements had been made and people’s care visits had not been missed. People, however, still experienced late care visits and they told us this impacted negatively on their experience of their care and meant they were often waiting for their care. They were not always told their care was running late and at times did not know who was attending to their visits.

¿ The provider monitored the quality of the service and asked people for their feedback about their care. We found what people told us about their experience and satisfaction of the service did not correspond with the positive feedback that had been recorded by the service.

¿ The provider’s action plan following our previous inspection had addressed some shortfalls but had not made the required improvements to the timeliness of people’s care visits.

¿ Recruitment processes had improved and people were supported by staff that had been appropriately vetted to ensure they were suitable to support people.

¿ Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns.

¿ The service assessed risks to people's personal safety, as well as staff, and plans were in place to minimise those risks.

¿ People were supported by staff that had received the training and support to provide effective care.

¿The information in people’s care plans had improved and gave staff guidance about people’s care tasks. The service was planning further improvements to ensure some information about people’s preferences and wishes would also be included.

Rating at last inspection: At the last inspection on 18 and 20 December and 8 January 2018 the service was rated Requires Improvement. (This report was published on 18 February 2018).

Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions, Is the service safe, effective, responsive and well-led? to at least Good

We met with the provider in March 2018 who told us they were introducing an electronic planning and monitoring tool to ensure there was a system in place to monitor missed and late care visits and ensure areas of concern found at our last inspection would be monitored effectively.

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous Requires Improvement rating. We also followed up on progress against agreed action plans to address the breaches in regulation we found at our previous inspection in December 2017 and January 2018. Previous CQC ratings and the time since the last inspection were also taken into consideration.

The overall rating for the service remains rated as Requires Improvement.

Follow up: We will ask the provider to complete an action plan to show what they would do and by when to meet the legal requirements and to improve the key questions ‘Is the service Responsive?’ and ‘Is the service Well-led?’ to Good.

We found what people told us about their experience and satisfaction of the service did not correspond with the positive feedback that had been recorded by the service. We asked the Services Manager to contact people and explore the reasons for this conflicting information and to report back to us their findings.

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more

This inspection was completed on 18 and 20 December 2017 and 8 January 2018 and was announced. Aromacare - Cotswold is based in the Cotswolds and provides a service to the local rural area.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.

The provider was given 48 hours’ notice because the service provides a domiciliary care service; we needed to ensure we would be able to meet with people where they were receiving the service. At the time of the inspection, the service was supporting 44 people in their own homes.

Not everyone using Aromacare - Cotswold receives a regulated activity; CQC only inspects the service being received by people provided with the regulated activity of ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

We carried out this inspection as a social worker shared information with us in November 2017 which indicated potential concerns about the care being provided and the management of the service. This inspection also examined these concerns.

Aromacare - Cotswold is a newly registered service and this was their first inspection and rating. We rated the service as ‘Requires Improvement’.

Aromacare - Cotswold registered with CQC in July 2017. The service had taken over people’s care from another care provider at short notice. We found some areas that require improvement and discussed these with the director and registered manager of the service. They were already aware of some of these concerns and had drawn up a detailed improvement plan with timescales during our inspection to start addressing the concerns we found.

There was a registered manager in post at the service; a registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was not always safe. People’s care visits had not always taken place as planned and people had experienced late and missed visits. Individualised contingency plans had not always been noted in people’s care plans to ensure consistent action would be taken to keep people safe when their staff were running late.

Staff had been provided with training on how to recognise abuse and how to report allegations and incidents of abuse. However, CQC had not always been notified of missed care visits which would require action from the service to ensure people were protected and safeguarded from neglect. Criminal checks had been completed for all new employees however records of references and work history were not always completed appropriately to ensure all staff were suitable for their roles.

The service was not always effective. When people’s care ran late people were not always supported to eat and drink at their planned times and in line with their preferences. We made a recommendation about individualised meal time support.

Training completed by staff included, first aid, safeguarding vulnerable adults, medication administration and moving and handling. Staff told us they had the training and skills they needed to meet people's needs. The service was adhering to the principles of the Mental Capacity Act 2005(MCA). Staff were receiving regular supervisions and attending team meetings.

Care and support plans were not always person centred. They had been updated and reviewed however important information was missing or not available to ensure staff would have all the information they needed to provide personalised care.

The service was not organised in a way that always promoted safe and quality care through effective monitoring systems. Some effective monitoring systems w