Lav Care Services- East of Anglia

Safeguarding was not well managed to ensure people were protected from the risk of harm and abuse. Incident and accidents were not always well managed and reported as legally required. There were ineffective systems in place to ensure appropriate action was taken with management analysis with oversight of themes and trends. Staffing and recruitment processes were not robust. Risks to people's health and safety were not always assessed or guidance provided to staff to reduce the risk of harm. People’s care plans did not always guide safe practice with effective review. Where incidents and safeguarding concerns had been highlighted, there was a lack of staff knowledge, skills and management oversight to ensure lessons were learnt and improvements made.

Although staff told us they understood the principles of the Mental Capacity Act (2005), they had not always been adhered to. Staff understood their responsibilities to ensure that people made less complex decisions about their lives. However, staff had failed to identify and report that people's capacity around more complex decisions had not been assessed, or appropriate processes followed.

Whilst people expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. Due to the shortfalls identified during this assessment, we could not be assured that people received a high quality, compassionate and safe service. We have taken these concerns into account when rating this key question.

People were at risk of receiving inconsistent support as an effective care planning system was not in place. Not all care plans contained sufficient information to ensure staff knew how to deliver people’s care in a safe and person-centred way. For example, people with complex support needs did not all have sufficient guidance for staff about how to support them to ensure theirs and others safety. People’s care and support did not always take into account current legislation and consider relevant nationally recognised evidence-based guidance. For example, plans to promote people’s independence and reduce the risk of social isolation. This information is important so that people's individual wishes are considered and planned for. The system in place to manage concerns and complaints was ineffective. Where people had raised concerns and formal complaints, these had not always been effectively recorded, managed, investigated, and/or responded to in accordance with the provider’s own policy.

The registered manager is also the nominated individual for the organisation and company director.

Quality assurance systems had failed to identify the areas of concern we highlighted during our assessment. Audits had not been effective in identifying shortfalls in relation to the oversight and monitoring of risk and evidence learning with planning to improve the safety and quality of the service.

We experienced some difficulty when requesting information from the registered manager. Information received was not always provided without repeated requests and within the timescales specified. People were not supported by a provider who prioritised people’s safety. There was a lack of openness and transparency when reporting incidents to stakeholders and CQC. Incidents and accidents were not always reported appropriately and when reported contained inconsistent information which put people at risk of harm.