Lauriem Complete Care Limited - Deal

Updated 28 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 24 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 22 August 2018 and ended on 24 August 2018. This was a comprehensive inspection. We visited the office location on 22 August 2018 to see the manager and office staff; and to review care records and policies and procedures. On the 24 August we visited the extra care housing unit and spoke to people who lived there who received a service. We also shadowed staff undertaking care calls to people to see how care was delivered.

The inspected team consisted of two inspectors and one expert by experience who undertook telephone calls to people who used the service and their relatives. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at the previous inspection report and notifications about important events that had taken place in the service which the provider is required to tell us by law. We used this information to help us plan our inspection.

We sought feedback from relevant health and social care professionals and staff from the local authority involved in the service on their experience of the service. We contacted Healthwatch. Healthwatch are an independent organisation who work to make local services better by listening to people’s views and sharing them with people who can influence change.

During the inspection, we visited three people in their own home and spoke to thirteen people and six relatives on the telephone to gain their views and experiences. We looked at eight people's care plans and the recruitment records of five staff employed at the service.

We spoke with one of the providers, the registered manager, the operations manager and four other members of staff. We viewed a range of policies, medicines management, complaints and compliments, meetings minutes, health and safety assessments, accidents and incidents logs. We looked at what actions the provider had taken to improve the quality of the service. We also used information from a recent survey of people undertaken by the provider.

Updated 28 September 2018

The inspection took place on 22 and 24 August 2018 and was announced.

Lauriem Complete Care Ltd - Deal is a domiciliary care agency. It provides personal care to adults who want to remain independent in their own home in the community. Most of the people who use this service are older adults. The service also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is a purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. The service provides ‘background support’ to all of the residents in the extra care housing. Not everyone using the service or background support receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the last inspection in July 2017 the service was rated overall as requires improvement. Following this we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, responsive and well-led to at least good. At this inspection we found that the service had improved and the service is now rated Good.

At the previous inspection there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In that the provider had failed to do all that was reasonably possible to mitigate risks to people's health and safety and there was a risk that people would receive inconsistent care and support. At this inspection we found that the provider had taken the appropriate action. The registered manager had assessed risks and there was a plan to minimise these risks in place. There was clear, detailed and appropriate guidance for staff. The care provided was consistent.

At the last inspection there was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In that the provider had failed to consistently assess, monitor and improve the quality and safety of the services provided and operate effective systems and processes to ensure compliance with the requirements. At this inspection we found that the provider had made the necessary improvements. The service was regularly audited to identify where improvements were needed and actions were taken.

A registered manager continued to be employed 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager ran both this service and the providers other service in Dover.

There were sufficient numbers of staff to meet people’s needs and cover the care calls provided by the service. Staff training was up to date and staff had the skills and knowledge they needed to support people. New staff had been recruited safely and pre-employment checks had been carried out. Staff were appropriately supervised and had annual appraisals. The provider undertook spot checks to monitor staff performance and competency assessments for medicine administration and manual handling.

People were protected from abuse and the risk of harm. Staff had undertaken training in safeguarding and understood how to identify and report concerns. Medicines were managed safely and people received their medicines when they needed them.

Peoples’ care met their needs. Care plans were up to date and accurately reflected people’s needs. Where people’s needs changed care plans were amended. Staff were aware of people’s decisions and respected their choices.

The service supported people to maintain their health and wellbeing. When people needed it they were supported with nutrition and hydration and to access health care. Staff used personal protective equipment and people were protected from the risk of infection.

People were treated with respect, kindness and compassion. People’s privacy was respected and they were supported in a dignified way. People were supported to maintain and increase their independence where appropriate.

People were provided with opportunities to express their views about the care and support they received. People had information on how to complain and complaints were investigated and responded to appropriately.

People told us the service was well-led. Staff and the registered manager understood their roles and responsibilities. Staff understood their responsibilities to raise concerns and incidents were recorded, investigated and acted upon. Lessons learnt were shared and trends were analysed.

The registered manager continued to work closely with social workers, referral officers, learning disability health professionals and other health professionals.