Cumbria Supported Living

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 that the provider met people’s needs.

This is the first assessment for this service. This key question has been ratedgood.This meant people’s needs were met through good organisation and delivery.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were at the centre of their care and treatment choices, and they decided, in partnership with staff and others involved in their care, how to best support their immediate and changing care and support needs.

People were involved at all stages, from the pre-admission assessment phase, through transition into the service, to care and support plan decisions and outcome reviews. People knew the content of their care plan, confirmed staff respected their preferences and were responsive to their individual needs.

Care plans considered immediate short-term needs, personal goals and longer-term objectives.

People were supported to take part in a wide range of person-centred activities that reflected their personal interests, preferences and aspirations. These included leisure activities,

community-based events, educational and occupational opportunities.

Staff respected people’s choices, decisions and matters of importance to them and these were given priority when providing care and support.

Families and professionals provided positive feedback about the impact of this approach.

One family said, “Staff have been responsive to their needs. By making it about her, staff have made great progress, and she has really warmed up to them.”

A healthcare professional said, “Staff have been brilliant. They have involved them in their care and broadened their experiences through sensitive engagement and meaningful activities."

Staff understood the unique and diverse health and care needs of people and their local communities. Staff supported people to ensure care was joined-up, flexible and supported choice and continuity.

The provider recognised the importance of continuity of care and developed staff rotas to meet people’s needs and preferences with a familiar care team. This allowed staff to build trusting and meaningful relationships with people, to really get to understand what was important to them and to support them to live their best lives.

People had a home they could call their own and had a sense of belonging and responsibility which empowered and enabled them to integrate into their community.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People could access their care and support plans and associated information via applications on staff devices. Staff were available to answer any questions or concerns as they arose. People were involved in care reviews where information was exchanged.

Staff supported people’s understanding by providing information in several formats. This included easy-read documents, pictorial and used communication aids to assist such as Makaton, flash cards and technology-based tools. This approach allowed people who may otherwise not be heard, be involved and engaged in information sharing discussions.

The provider published newsletters to share information with people, and many were invited to attend on-line video conference calls with the organisational executive team.

Staff used internal and external resources to facilitate effective information sharing with people. This involved engaging in research with people, discussing information on personal care and support issues and ensuring people were fully informed of key events in the service.

People had been informed by staff about our assessment, the inspection team attending and what this meant for them.

The provider had processes to gather feedback from people.

Staff listened to and involved people at all times. People’s feedback was recorded in several ways such as at care reviews and meetings.

Staff made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Family members could attend engagement webinars, training events and access various resources available on-line for their support and involvement.

Family members reported how staff, “Take on board my feedback, look into it and respond” and how they were, “Involved in reviews, respond to my calls and I feel as though my voice is welcomed and valued.”

Healthcare professionals reported where concerns had been raised, service management responded and improvements had been noted in clinical care, support and outcomes for people.

The provider made sure that people could access care, support and treatment in a timely manner in accordance with their needs and requests.

Staff were flexible in their approach to personal requests allowing people to determine when they received care and from whom. Key contact information was recorded in people’s care plans which enabled staff to speak to the right people at the right time. This supported good communication, timely access and referral.

Staff ensured people had equal access to healthcare services such as GPs and dentists.

Staff supported people to make appointments which maintained their independence and ownership. Some people chose to attend external appointments and others received care from professionals who visited them at home. Every person had an annual healthcare review at a time suitable to them to ensure their care and support needs were being met. This flexible and person-centred approach by the care and support team promoted people’s health and wellbeing.

People accessed care and specialist support services without difficulty or obstruction and knew the healthcare professionals involved in their care.

Staff also supported people to engage and get involved with services in their local community regardless of their health conditions, perceived limitations or accessibility issues. A family member told us, “He’s doing a lot more and has never looked back.”

The provider had guidance for people to support them and exercise their rights to vote. Staff had developed easy-read practice cards and voting passports to empower people to get involved in decisions which may impact them.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The pre-admission transition process allowed staff to gather information about people who were referred into the service before they moved in. This provided staff time to build relationships and trust. Staff agreed a bespoke care package to ensure they could meet people’s needs and prevent any inequity or unfavourable outcomes. People’s individual background and personal circumstances were given due consideration, and this minimised the risk of any later gaps in the care and support required which could otherwise lead to setbacks.

Each person had an individual and person-centred plan of care. Staff had a good understanding of people’s needs and were respectful of their rights, choices and decision making. Staff were trained in equality and diversity and there were no concerns raised by people about discrimination within the service.

Staff ensured people maintained important relationships and family connections to preserve those ties and the positive impact this had on health and wellbeing. This provided a sense of stability and continuity. One person told us, “I feel alive and love my life.”

Healthcare professionals reported seeing positive physical, emotional and behavioural changes for people they had been supporting since they moved into the service. They acknowledged how staff had supported people to reconnect with their community in a safe, controlled and empowering way.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

There was limited evidence in care plans to show how people were supported to plan for future health changes including deterioration and emergencies, or to capture what was important to them should they be approaching end-of-life.

Staff told us people and their families did not always feel ready to discuss future planning, including end‑of‑life wishes. These conversations were sometimes deferred while staff focused on building trusting relationships. However, staff did recognise this to be an area for further development and improvement.

The provider was looking at a wider piece of work across the organisation to enhance the care and support for people and families in discussing and planning for this important stage of life. The ‘Last Wishes’ booklet was in consultation at the time of the visit.

At the time of the assessment, there was no one receiving end-of-life care.