The inspection took place on 19 and 21 July 2016. The inspection was announced. Lauriem Complete Care Limited – Ditton is registered as a domiciliary care agency, providing personal care to people in their own homes in the community. They provide services to any people who need care and support. The agency provides care services mainly to people living in the West and North Kent areas. There were approximately 155 people receiving support to meet their personal care needs on the days we inspected.
There were two registered managers based at the service, one of whom was the provider. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe when receiving care from Lauriem Complete Care Limited staff and they knew who to talk to if this changed. Staff had a good knowledge of how to safeguard vulnerable adults from abuse. Staff had described instances where they had raised concerns in the past and these had been acted upon. They understood their responsibility to report concerns and where to go to outside of the organisation should the need arise.
Risks to individual people and their circumstances had been identified, with actions put in place to reduce the risk and maintain people’s safety. People’s home environment, internal and external, had been checked for hazards before support commenced, helping to keep people and staff safe. Most people did not need help to take their medicines, however some people did. As well as attending training courses, regular competency checks were carried out on staff to ensure their continued capability to safely administer medicines to people. The provider had identified where some staff were not recording to the expected standards when administering peoples medicines. They had put actions in place to rectify this in order to continue to provide a safe service.
The provider had robust recruitment processes in place to make sure new staff were suitable to work with vulnerable people in their own homes. Enough staff were available to be able to run an effective service, responsive to people’s needs. People told us that staff always stayed to support them for the time they were allocated. Staff had suitable training at induction when they were new as well as regular updates. Additional training was available to make sure staff were skilled and confident to cater for specialist needs, such as to support people living with dementia. Staff had ‘spot checks’ to make sure their practice continued to be safe and of good quality.
Although most people looked after their own healthcare needs or had a family member who helped with this, staff supported people who needed assistance when requiring health care appointments or advice.
People told us they made their own decisions and choices and staff were clear that people were in control of their care and support. Mental capacity assessments had been undertaken where appropriate following the principles of the Mental Capacity Act 2005. People’s families were often involved if their loved ones needed support to make decisions and this was clearly recorded.
A caring approach was shown by staff, people made many positive comments about the staff who supported them. Most people had regular staff providing their care and support who had got to know them well, creating a confidence and trust. People were give a service user guide at the commencement of their care and support with the information they would need about the service they could expect.
A care supervisor undertook an initial assessment of people’s personal care needs so the registered manager could be sure they had the resources available to support people. People had a care plan that detailed all the individual support required as a step by step guide for staff. People, and their families if appropriate, were involved in the process to ensure the support in the care plan expressed how they wanted their care and support to be undertaken.
How to make a complaint was included in the service user guide, and the people we spoke to knew how to make a complaint if they needed to. The provider asked people for their views of the service by completing a questionnaire every six months at their care plan review. A further, more in depth survey was undertaken once a year. The provider analysed the feedback received and produced a plan to improve the service as a result.
People and their families generally thought the service was well run and said the staff in the office were usually helpful when they needed to contact the office.
Staff were happy with the support available for them and said that suggestions or concerns were responded to quickly. They found the managers approachable and would be happy to raise any concerns with them, confident they would be acted upon.
The provider had a comprehensive quality monitoring system in place to make sure the service provided remained safe and of good quality. A range of auditing processes were undertaken at various intervals with actions put in place where improvement was required. People and staff were asked their views of the service and the registered manager acted on the feedback provided to improve the quality of support to people and staff.