The inspection took place at the service’s office on 18 and 20 July 2017 and in people’s homes on 19 and 20 July 2017. Lauriem Complete Care Ltd - Deal, is a privately owned, independent provider of community health and social care services. The service provides care and support to adults who want to retain their independence in their own home. It provides a service to mainly older people.
There was a registered manager employed at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 was responsible for the day to day control of the service.
Risks to people were identified, monitored and reviewed. Risk assessments gave staff guidance on how to minimise and manage risks. However some care plans needed additional information to guide staff in the event of an emergency such as people suffering a seizure or if people living with diabetes required medical attention. When people needed specialist equipment, such as a slide sheet to help them move in bed, this was not consistently recorded.
People said they generally had regular carers and the calls were usually covered in time of sickness or annual leave. However, people told us they did not know which staff would be supporting them each day. Some people told us this did not pose a problem for them other told us it made them rather anxious. There was a risk that people would receive inconsistent care and support.
Quality audits were completed to monitor and assess the service. During the inspection we found some files which had not been fully updated.
People told us they trusted the staff and that they felt safe. One person said, “Yes I feel safe. I would have no hesitation in phoning if there was an issue”.
People were protected from risks of abuse and avoidable harm. Staff knew how to protect people from the risks of abuse and the action they needed to take to keep people safe. Staff completed regular training about how to keep people safe.
Some people needed support and guidance from staff to take their medicines as prescribed by their doctor. Staff were trained to support people with their medicines and senior staff checked they were competent to do so.
There were sufficient staff employed to give people the care and support they needed. The provider made sure recruitment checks were carried out to ensure staff were honest, trustworthy and reliable to work with people in the community. Disciplinary processes were followed when needed.
People told us they received care and support from staff who were trained. People said, “The staff are well trained” and “Carers are definitely well trained”. Staff told us they regularly completed training to keep their knowledge and skills up to date and in line with best practice. Staff attended regular supervision meetings and had an annual appraisal.
People felt informed about, and involved in their healthcare and were empowered to have as much choice and control as possible. Staff were aware of the importance for people to be supported to make decisions.
People were supported to maintain a healthy and balanced diet. Staff monitored people’s health care needs and referred people to health professionals when needed.
People said their care and support was provided by staff who were caring and kind and who respected their privacy and dignity. People said, “They do a good job. They don’t do it for the money but to look after people. It’s not an easy job”, “They are very caring” and “They always speak to me in a nice manner. They are nice people”.
People were involved in their care planning, knew about their care plans and said their needs were reviewed. Staff were knowledgeable about people and their preferred routines.
People knew how to complain and there was information in their care folders of who to contact to raise any concerns. People said they would not hesitate to speak with their family or the staff if they wanted to complain. People were asked to feed back their views on the quality of service through surveys, reviews and spot checks.
People told us they felt the service was well-led. There was an open and transparent culture. Staff said the management were very supportive. Staff were clear about what was expected of them and their roles and responsibilities. Leadership was visible at all levels.
Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager submitted notifications to CQC in line with guidance.