Archived: Lauriem Complete Care Limited

Updated 12 October 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 23 July 2018 and ended on 30 July 2018. This was a comprehensive inspection. We visited the office location on 23 July 2018 to see the manager and office staff; and to review care records and policies and procedures. On the 30 July 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 one inspector 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 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 four people in their own home and spoke to 12 people and one relative on the telephone to gain their views and experiences. We looked at seven 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 and five 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 also looked at the providers survey.

Updated 12 October 2018

The inspection took place on 23 and 30 July 2018 and was announced.

Lauriem Complete Care Ltd 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 adults who want to remain independent in their own home. 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 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 Lauriem Complete Care Ltd or the 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 this inspection we rated this service is rated as ‘Requires Improvement’ as we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014.

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 Deal.

Risks to people had not always been assessed and there was not always a plan in place to minimise these risks. This included risks associated with nutrition and hydration. When people’s circumstances changed their care plans and risks assessments were not always updated to reflect these changes.

Medicines were not always managed safely. Medicine administration records were not always complete. Non-prescribed medicine was treated in the same manner as prescribed medicine and this led to confusion.

Care plans were not always up to date and people’s preferences and wishes were not always taken in to account. When people needed emergency medical assistance they were supported to do so. However, some people needed referrals to health care professionals for further support and equipment and this was not always done.

Complaints and incidents were not always recorded appropriately and were not always investigated and acted upon.

Auditing of the service to check the quality of service provision was not consistent and did not identify the concerns found on inspection. Systems and processes were not always effective in ensuring that the service was well led and meeting the requirements of the regulations.

There were sufficient numbers of staff to meet people’s needs and cover the care calls provided by the service. New staff had been recruited safely and pre-employment checks had been carried out. Staff were appropriately supervised and had annual appraisals. Staff training was up to date and staff had the skills and knowledge they needed to support people. The provider undertook spot checks to monitor staff performance and competency assessments for medicine administration and manual handling. Staff at the service had supervision and appraisals as appropriate. However, staff were not always happy and did not always feel supported in their role.

People were protected from abuse. Staff had undertaken training in safeguarding and understood how to identify and report concerns. Staff had access to gloves and aprons 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 consent to care was sought and their choices were respected. The service was meeting the requirements of the mental capacity act 2005.

The provider undertook an annual survey and people were provided with opportunities to express their views about the care and support they received.

The service worked in partnership with other agencies and attended events and conferences to develop and share best practice.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.