Lifeways Paragon Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always ensure people were placed at the centre of decisions about their care and treatment. Whilst staff were able to describe people's preferences, likes, dislikes and preferred routines, this was not consistently reflected in care records. Records of care delivered were often task-focused and did not always demonstrate how people had been involved in decisions about their care, or that support had been provided in accordance with the preferences outlined in their care plans. For example, several daily records did not evidence people had been offered meaningful choice regarding activities. In addition, activities recorded as having taken place were not always consistent with people's stated interests and preferred activities. Records did not always assure us people were consistently receiving care and support in a way that respected their preferences. Further improvement was required to ensure care records clearly demonstrated a person-centred approach and evidence how people were actively involved in decisions about their daily lives and support.

However, positive behaviour support plans demonstrated a person-centred approach by clearly detailing factors that could cause people emotional distress, and the support measures staff should take. This provided staff with the information needed to deliver consistent and individualised support.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Staff and leaders worked collaboratively with a range of external health and social care professionals to help ensure care was coordinated and responsive to people's changing needs. For example, the provider had strengthened arrangements for the safe management and delivery of Percutaneous Endoscopic Gastrostomy (PEG) care through improved partnership working with relevant healthcare professionals. This included seeking specialist advice, coordinating staff training and competency assessments to help ensure staff had the skills and knowledge required to provide safe care. These arrangements helped promote a consistent approach to care and supported continuity for people they supported.

The provider supplied appropriate, accurate and up-to-date information in formats tailored to people’s individual needs. Care plans took account of people’s specific communication needs and guided staff accordingly. Staff understood people’s individual communication needs, and we saw how information was made accessible to people. For example, an easy read service user guide was made available to people to give them information about the service including how to contact them and how to make a complaint.

Theproviderdid not always involve people in decisions about their care or tell them what had changed as a result. Care plans were regularly reviewed; however, several records we reviewed did not assure us people were consulted and involved in these reviews. Where decisions were made in relation to people’s care, records did not always demonstrate people and their significant others were involved.

However, the provider sought people’s feedback about the care provided through regular surveys and we saw this feedback was used to identify improvements to the service. People and their relatives felt confident if they raised any concerns these would be dealt with appropriately by leaders. Comments included, “I feel when I speak to someone, they listen.”

The provider ensured people were able to access the care, support and treatment they needed in a timely way. Staff supported people to attend annual health checks, GP appointments and routine consultations with healthcare professionals involved in their ongoing care. This promoted positive outcomes in relation to people’s health and wellbeing.

The provider demonstrated flexibility in responding to people's changing needs and worked proactively with local authorities to ensure support arrangements remained appropriate. For example, following changes in a person's mobility, the provider identified their needs had changed and requested a review of their support. This demonstrated a proactive approach and ensured the person could access the support they needed.

Staff and leaders did not always operate effective systems to identify people who may be at greater risk of experiencing inequality in their care, support or outcomes. Whilst opportunities for engagement were available to many people they supported, we found not all people were actively encouraged or supported to participate in meaningful activities. There was limited evidence this had been recognised through the provider's monitoring systems which increased risk of people becoming socially isolated. Further improvement was needed to ensure monitoring systems effectively identify potential inequalities in people's experiences and outcomes.

People were supported to plan for important life changes. People’s care plans documented their wishes and goals for the future and staff were able to describe how they supported people to achieve their goals.

However, there was limited evidence within care plans of how progress towards achieving these goals was being monitored and reviewed. We shared our findings with leaders; they told us about improvements they were currently making to their care planning system to better capture people’s progress towards achieving their future goals.