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 reflec

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 know