Laura Care is a domiciliary care service providing a service to people living in their own home. This announced inspection took place on 17 December 2018 and 02 January 2019 We gave the provider 48 hours’ notice that we would be visiting the service because we wanted to make sure staff and people would be available for us to speak with. At the time of the inspection there were 12 people using the service.

At our last inspection on the 30 June 2017 we rated the service as requires improvement in safe and well led. At this inspection we found that the required improvements had been made.There was a registered manager in post at the time of our inspection. 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.

Staff had been trained in safeguarding people. There were procedures in place to follow in an emergency. Staff knew what action to take if they identified any safety concerns during their work. General risks to individuals when providing support were identified so staff had the information they needed to support people safely. Staff and records confirmed that there were enough staff to meet peoples care needs. Care staff had completed training to enable them to support people with their medication if required.

People benefitted from continuity of staff so relationships were built and people did not have to endure different staff for their care. Staff had received ongoing training to ensure that their skills were updated with current knowledge. The service followed a recruitment process which ensured staff were recruited safely.

Staff were caring and treated people with dignity and respect. People's choices and independence was respected and promoted and staff responded with kindness, maintaining people’s dignity. People’s care needs were regularly reviewed to ensure the care provided was up-to-date. Staff had an awareness of the Mental Capacity Act and the principles of the Act.

People and relatives felt they could speak with the registered manager about their worries or concerns and felt they would be listened to and action would be taken. The provider had quality assurance and audit systems in place to monitor the care and support people received to ensure the service met people’s needs.

This inspection took place on 3 May 2017 and was announced. The provider had been given 48 hours’ notice of the visit to the office so that we could be sure someone would be available to meet with us. At our last inspection in February 2016 we found that the provider required improvements to be made in three of the key questions. The other key questions were rated as good at that time.

Laura Care Agency is registered to provide personal care to people who live in their own homes. On the day of our inspection they were providing care to 13 people. There was a registered manager at this 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 and associated Regulations about how the service is run.

We found people received a service that was based on their personal needs and wishes. Changes in people's needs were identified and responded to. Risks people might experience with their care and support or risks related to their home environment were being managed well. People received support with their medicines but we could not be sure if the recording of when the medicines had been given was accurate . We recommend that the registered manager considers the NICE Guidance ‘Managing Medicines for adults receiving social care in the community.”

People's needs had been assessed before they started to receive support from the service and people had been involved in developing and updating their care plans. We found the information contained in the care records was individualised and clearly identified people's needs and preferences.

Staff had been provided with induction training and regular refresher training to update their knowledge and skills. Staff had a clear understanding of the procedures in place to safeguard people from abuse. Staff were well supported and received regular supervision and training.

We found the service employed enough staff to meet the needs of the people being supported. The support provided was from a consistent group of staff who had been safely recruited. People who used the service had no concerns about how the service was staffed.

People and relatives told us they were cared for by kind staff who knew them well. People and staff knew how to make a complaint and felt confident that it would be dealt with well.

The provider had not established adequate quality monitor processes to identify if the service was meeting people’s needs or how it could be improved. Audits had not always led to improvements in the quality of the service. Information was not reviewed for trends and to identify learning opportunities.

This inspection took place on 10 February 2016 and was announced. Laura Care Agency provides personal care to sixteen people who live in their own homes. Some people using the service were living with Dementia. This was the first inspection of this service since they were registered with the Commission in February 2015.

There was a registered manager 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.

People told us they felt safe whilst receiving support from staff. Staff were aware of the possible signs of abuse and could tell us about appropriate action they would take should they have any concerns.

People told us that they received support from a consistent staff team who knew their individual needs well. People were able to state the times of day they wished to receive support and gave examples of when they had been able to change support times to meet their needs.

Staff had received training in medication administration. We found that improvements were needed in the recording and monitoring of medication administration.

The Mental Capacity Act (2005) applied to some people using this service. While staff were aware of the need to offer people choices and seek consent in their care they had not received specific training in this legislation.

Staff told us they felt supported in their role and there were systems in place for staff to feedback concerns. Training was provided to staff. However, staff had not received training on some people’s health conditions.

People told us they felt cared for. People and their relatives were involved in planning their care to ensure they received care how they wished. Care was reviewed with the person. In some instances care plans had not been clearly updated following a change in a person’s needs. This meant that people may not receive care that reflected their most current needs.

People and their relatives were aware of how to raise concerns or complaints. Where concerns had been raised, relatives informed us that the provider had taken action to resolve the concern for the person.

People were happy with how the service was managed. Systems were in place to monitor the quality of the service although these systems were not always robust and had not consistently identified where improvements were needed.