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.