Lauriem Complete Care Limited - Ditton

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 operate robust systems to ensure people were at the centre of their care and treatment choices. The provider had not always made sure people received regular reviews to ensure their care records contained up-to-date assessments and guidance to support staff to meet people’s needs. People’s records did not always contain the person-centred details that the managers and established staff knew about people. There was a risk newer staff might not know how to meet people’s needs, and in a way that they preferred. The provider took action following our inspection feedback to implement new technology to help support people’s care reviews and create more personalised care records.

Despite systems not being robust, staff worked in partnership with people, to decide how to respond to any relevant changes in people’s needs. The care people received was person-centred. Staff understood how to provide person-centred care and followed this in their practices. A staff member told us, “We have been trained to provide person-centred care. We have been trained to keep opinions to ourselves and to provide a great level of care regardless of the person receiving the care.” Another staff member said, “Keeping the person’s needs and preferences at the centre. For example, respecting routines, hobbies, or how they like their home arranged.”

People and relatives felt the staff provided a person-centred service when they supported people with their care needs. A person said, “Carers know how I like my food cooked, know that I like hot milk on my breakfast cereals, don’t have to tell them.” A relative said, “We are very happy with all of the carers, [relative] has female carers all the time, this is through choice.”

A professional told us, “I have felt they have always been very responsive and client-centred."

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff received the training they needed to meet people’s needs and worked in partnership with other professionals to ensure people received joined up care that met their needs. A staff member said, “We work really well as a team, we read all the care plans and update notes to make sure there is continuity for the client.”

The provider had systems in place to try to support people to have continuity of carers so that people would receive care from staff they knew and who understood their needs.

Most people felt they had good continuity of care staff. A person said, “It’s normally the same girls that come to see me.” A relative told us, “[Relative] has a group of regular carers, and this is so much better, [relative] has got to know them and they her. [Carers] can tell if [relative] is off-colour.” Whereas, another person told us, “They vary and there are lots of different carers, they lack consistency.”

Professionals were positive about the care provision from the service and felt the provider supported people to have continuity of care. A professional told us, “They are good at trying to keep the same staff members to support someone which provides good continuity for the people they support and makes them feel more comfortable. They were good with a [person] they supported who had [an increase in their support needs], [the provider] ensured to provide the same person where possible which was reassuring for the family.” A healthcare professional fed back, “One of my clients has consistent carers who visit, and this has been the same throughout my intervention with [client]. [My client] speaks very highly of them.”

Staff were flexible to ensure at each care call they met people’s needs. A relative told us, “Carers are very adaptable, if I am out, they will give [relative their] meal."

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider had recently completed a review of their service and found some areas needed improvement. People’s care records did not always contain up-to-date information including about people’s communication needs. People and relatives had not always been involved in recent reviews of their care or opportunity to feedback about the service. The provider was reviewing their systems and processes to ensure there were more regular opportunities to include people and relatives where appropriate. The provider following our inspection was using technology to complete assessments with people so that the information gathering was more tailored and specific to individual people’s needs.

It was documented in people’s care records where they required glasses to support their vision or hearing aids to ensure people could receive information effectively. Staff were aware of how to communicate information with people to meet their individual needs and gave examples of how they adapted their communication to ensure it was effective and impactful. A staff member told us, “I let non-verbal clients know I’m there by rubbing [their] shoulders and let them know that I am there. I watch them and look at them for response.”

A relative told us how staff had supported their family member with good communication to ensure all their needs were met safely and encourage their independence. They said, “[Staff] encouraged [relative] to eat and drink, they offer [relative] breakfast downstairs and make [them] feel safe by walking with [them] downstairs…reminding [relative] to hold onto the rail."

The provider did not always make it easy for people to share feedback and ideas about their care, treatment and support. People and relatives told us that they didn't get surveys or newsletters from the company. They also told us it had been a long time since they had reviews about their care. The provider had identified this as an area for improvement prior to our inspection. A system was being implemented to schedule more regular contact with people and relatives to review and gather feedback about their experience of care.

People and relatives knew how to make a complaint. Most people and relatives told us they had not needed to make complaints but felt able to feedback about their care and that this was listened to. A person told us, “I spoke to one of the managers about a carer who came, they never talked, I haven’t had them again.” Another person said, “One holiday cover came out [earlier than the preferred time]. I spoke to the office, told it wasn’t suitable, and was asked what time suited me. I felt that they listened to my requests.” A relative said, “Communication is excellent, and I get regular updates about [relative] from the manager…I have never needed to raise a concern or make a complaint, and I really don’t think I will need to.”

However, some people felt they did not always have an opportunity to discuss care or were not always listened to. A person said, “It depends on who you get some are very responsive and others should not be answering the phone.” A relative said, “The other thing is we have no contact from the manager to see if everything is all right.”

Formal complaints had been investigated as required however not all negative feedback or concerns were actioned in a timely manner.

Staff made sure that people could access the care, support and treatment they needed when they needed it.

People were supported by staff to have access to relevant healthcare professionals to meet their individual needs. Staff told us they advocated for people. For example, a staff member said, “Externally I have supported [people] by reporting [a healthcare professional]to their bosses for late attendance.” Staff supported people so that they were able to attend appointments.

A professional confirmed, “Lauriem support people equally to access adult social care when needed.”

Where people needed equipment or aids to support them to live in a safe environment, mobilise or communicate, staff ensured people had access to these items. For example, a person who used an adapted drink cup had this documented in their care notes. Staff ensured they also left snacks and drinks for people to easily access in-between their care call visits so they could continue to have their needs met when staff were not there.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider asked about people’s protected characteristics during their assessments and documented care needs in the care plans in relation to religious beliefs, cultural identity, gender, sexuality, and any disabilities.

For people who had visual impairment, records contained prompts to remind staff of the impact for people and encouraged not to move items out of place and ensure the environment was kept as normal for the person.

Staff told us they supported people to be able to continue to make choices about their daily lives and care. For example, staff gave people options to choose from for the clothes they wanted to wear. Staff were observant and tailored their care to support people’s communication needs. A staff member told us, “We do have some clients with hearing difficulties, we are speaking loudly and clearly so they can understand. We also make notes if their hearing is getting worse.” A relative told us about their family member who no longer communicated verbally. They said, “[Staff] show respect, are polite, they took the time to find out about [relatives’] history, [their] life and work…carers talk to [relative] even though [they] don’t respond."

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service was not supporting any people at the end of their lives at the time of our inspection. However, the provider had recorded information about people’s end of life wishes and their Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) status.

A staff member said, “I know [people’s end of life wishes] because the respect form will be in the house. With medications sometimes, it can be in their folder from the district nurse.”

The provider identified people’s goals and aspirations as part of their care planning and recorded this. For many of the people whose care records we reviewed this included supporting people in a way that enabled them to remain in their own homes for as long as possible.