Laniwyn Care Services received an overall rating of Requires Improvement following a focused inspection of Safe and Well-Led, driven by concerns over generic and inaccurate care plans, retrospective record-keeping, and absent provider-level audits, constituting a breach of Regulation 17. Strengths included safe medicines management, robust safeguarding awareness, and a responsive registered manager who initiated improvements during the inspection itself.
Concerns (7)
criticalCare planning: “one support plan addressed a different person's PEG management. This did not record how staff would monitor the PEG, the frequency or amount of water to use to flush or how to manage blockage”
criticalRecord keeping: “daily notes by care staff had been retrospectively entered into people's care record. This included when medicines had been administered.”
criticalGovernance: “There were no audits completed by the provider to monitor and assess the quality of the service and ensure the registered manager had maintained effective oversight.”
moderateStaff training: “recommended higher level specialist training had yet to begin. One staff member told us, 'I think we need better training knowing how to respond when the clients are upset'”
moderatePerson-centred care: “Risk assessments were generic and not developed to meet the specific needs of people... Care plans were copied and pasted with generic information”
minorCommunication with families: “Relatives however did say communication with the office could be improved”
minorInfection control: “where staff did not wear PPE, a risk assessment to support this decision had not been completed. The registered manager took immediate action to assess this area during the inspection.”
Strengths
· Medicines were managed safely with regular competency checks and MAR chart audits; relatives reported no issues with medication administration.
· Safe recruitment practices were followed, including Disclosure and Barring Service checks before staff began working.
· People felt safe using the service and staff were described as kind, gentle and respectful.
· Safeguarding and whistleblowing policies were in place; staff and management understood their responsibilities.
· The registered manager demonstrated responsiveness to inspection findings, implementing changes immediately including suspending new care packages.
Quality-Statement breakdown (8)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Engaging and involving people; Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourGood
Laniwyn Care Services improved from Requires Improvement to Good overall, with Safe and Well-led both improving to Good due to better risk management, recruitment, governance and a new manager driving quality assurance. Minor areas for development remain around formal recording of lessons learned, face-to-face induction and supervision, and sharing complaint outcomes with staff.
Concerns (5)
minorIncident learning: “Staff discussed and reviewed incidents to share lessons learned... However, these were not formally recorded in meeting minutes.”
minorStaff training: “new staff did not receive a face to face induction meeting and felt this would be helpful. The manager said this would be reviewed.”
minorSupervision / appraisal: “Staff felt supervision would be more effective if face to face... 'it would be good to be able to discuss other things face to face.'”
minorComplaints handling: “Complaints and their outcomes were not shared with staff to help develop staff awareness of knowledge as part of lessons learned.”
minorEnd-of-life care: “No person at the time of the inspection required end of life care. End of life training was planned to be provided to staff.”
Strengths
· People felt safe and well cared for with staff who knew how to keep them safe from harm
· Sufficient, appropriately recruited staff available to meet people's needs with reliable timekeeping
· Risks to people's health and welfare identified and mitigated, with comprehensive staff understanding of changing needs
· Medicines administered safely by trained staff with competency checks and management spot checks
· Robust infection prevention and control practices including additional measures during recent epidemic
Quality-Statement breakdown (19)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced diet