This focused follow-up inspection of Laurel Homecare Ltd found the service had remediated a previous breach of Regulation 13 (safeguarding), with both Safe and Well-led key questions improving from Requires Improvement to Good. The overall rating moved to Good, underpinned by robust safeguarding systems, effective governance, and a strong person-centred culture.
Strengths
· Staff received safeguarding training and knew signs of abuse; previous breach of regulation 13 remediated with no further breach found.
· Registered manager monitored staffing capacity ensuring visits were not cancelled and people received consistent care from familiar staff.
· Senior staff member held lead role for medicines administration with regular competency assessments and continuous improvement focus.
· Open, supportive culture with staff describing management as accessible and responsive inside and outside office hours.
· Effective monitoring systems including audits of accidents, incidents and near misses driving continuous improvement.
Quality-Statement breakdown (10)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
Laurel Homecare Ltd was rated Requires Improvement overall following a focused inspection, with a breach of Regulation 13 identified after two safeguarding allegations were not reported or acted upon appropriately and a warning notice was served. While safeguarding and governance shortfalls persisted, improvements were noted in risk management, medicines, recruitment, training and partnership working, and the effective key question remained Good.
Concerns (5)
criticalSafeguarding: “we identified two examples of allegations of abuse that had not been addressed safely with delays in both reporting and action to protect people.”
criticalSafeguarding: “The management team had not reported potential safeguarding incidents to all appropriate agencies.”
moderateGovernance: “We identified some incidents that should have been reported to the Care Quality Commission (CQC) as statutory notifications.”
moderateLeadership: “management understanding of safeguarding responsibilities remained an area requiring improvement.”
minorMedication management: “One person had sometimes been receiving medicines without the appropriate time gap. This was addressed and rectified before the inspection was concluded.”
Strengths
· People told us they felt safe with staff and praised their caring approach
· Effective infection prevention and control procedures were in place; staff used PPE appropriately
· Staff received an induction aligned to the Care Certificate and were trained and assessed as competent for medicines administration
· Improvements made in risk assessments with a new recording system to flag emerging risks
· Open culture within the staff team, with staff feeling supported and valued by senior team
Quality-Statement breakdown (15)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood