Lauriem Complete Care Limited - Ditton

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Some people and relatives told us they had not met with staff to review their care needs in a long time. Records we reviewed showed some people had not had their care needs reviewed and updated in a year and a half. Some people’s needs had increased and changed, and these were not updated in their care records. The provider was aware of this and put a plan in place to ensure people received more regular reviews in the future. They told us they aimed to make contact with people at least 4 times a year to discuss their care and gather feedback. We will check this at our next assessment of the service.

Staff told us they used people’s risk assessments and care plans to understand what people’s needs were and how to provide support. However, records we reviewed were not always up-to-date and lacked guidance to support staff to meet people’s needs. Staff were observant and noted when there were changes in people’s care and support needs in their daily notes. They increased the level of support given when they noticed people needed this.

Staff also told us they spoke with people or relatives to understand their needs. Staff told us they communicated with each other regularly to keep an up-to-date understanding of people. A relative commented that when there were new carers for their relative, new staff shadowed more experienced staff to ensure staff knew how to meet people’s needs.

People and relatives felt that the care staff attending their care calls provided care and support to meet their needs. A relative told us, “A full assessment was carried out by the manager with [relative] and I; and what care was needed was discussed in detail and between us we came up with a plan and the carers do everything [relative] needs."

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People had not received regular reviews of their care needs, and the provider had not always carried out regular, robust auditing to ensure people were receiving evidence-based care and treatment.

Despite this, care staff delivering people’s care did maintain communication with people and their relatives where applicable. They also escalated concerns to the office and management team to support people to receive care that was in line with best practice and standards. A relative told us, “The carers understand [relative’s] condition, and this makes such a difference.”

People and relatives told us that the carers checked their skin and informed the district nurse if there was a concern. For example, a person said, “Carers are on the ball. I have been doing some exercises, didn’t notice my skin was rubbing on the cushion, carers noticed the skin behind my knees was red, took photos and sent them straight to the district nurse."

The provider did not always work well across their teams to support people. The previous management team at the service had not always worked well to ensure the service was well managed and support staff to meet people’s needs effectively. The provider had identified this and made recent changes to the management team to better support effective team working. Staff told us the management team were supportive. The provider was also in the middle of some business changes. Some staff feedback that communication around this had not always been effective.

Staff worked well together to meet people’s needs when providing their daily care. A person told us, “Carers work well together to keep me safe when moving me out of my bed.” Staff agreed, “As a team we work well.”

Staff also worked in partnership with other professionals to promote positive outcomes when supporting people. For example, a relative told us, “The carers left a note last week to say [relative] had a bad knee and needed to see the Doctor.” A professional told us, “I feel the service works closely with me to ensure we support people in the best way possible. They are quick to update us and work collaboratively to resolve a situation or ask for advice on how they can support."

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to meet their nutritional and hydration needs. A person told us, “Carers always make sure I have something to eat. I choose what I eat, and the carers get meals ready. Always check if I had a drink and then leave me with a fresh drink.” Staff also supported people to mobilise, maintaining their independence as well as their health and well-being.

When there were concerns about people’s physical health staff escalated any concerns to relevant professionals. A person told us, “A couple of weeks ago I fell and hit my head [staff] rang 111 and stayed with me until the ambulance came. They have also stayed with [relative] until the ambulance has arrived when [relative’s] chest has been a bit wonky."

Staff routinely monitored people’s care and treatment to continuously improve it. A staff member told us, “We write what they have for meals what has been eaten and what has been drunk or how wet a pad is. Any concerns we let the office know. Also notes on the app so other carers are aware.”

Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People and relatives commented that the care staff were observant. A relative told us, “The carers check my [relatives’] skin and worked together with the district nurses to clear up an ulcer on [their] bottom. The district nurses commented on how well the carers look after my [relative]; the carers always tell me if there is something on [relatives’] skin they don’t like.” Another relative said, “Carers are very observant, they noticed a blister on [relative’s] leg and pointed it out to me and checked it was healing at each visit.” A person told us, “[Staff] always check for bed sores and make sure I am kept well creamed."

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and relatives said carers knocked before they came into their home, and when they were doing personal care, they would check first before assisting. For example, a person told us, “All the carers I’ve had have been taught on how to use the hoist. Always check with me before they move me.”

Staff were aware of people’s capacity to make decisions. Staff told us they supported people to make decisions about their care. A staff member said, “I suggest things and let [people] decide. For example, with clothes or routines, I offer options and respect their decisions.”

Staff also understood people’s right to refuse care and respected this. Records we reviewed showed staff clearly documented when people had refused aspects of their care and that their decisions were respected.

Where people lacked capacity to make decisions about their care this was recorded in their care records and the provider worked with relevant others to make decisions in the person’s best interest.