T Lives Healthcare Ltd

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• 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 to rate this service.

This key question has been rated requires improvement.

This meant people’s needs were not always met.

This service scored 61 (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 care plans were person-centred, accurate or complete. Records did not consistently reflect people’s current needs, preferences and circumstances, and some contained contradictory information. For example, information about one person’s eyesight differed across records and from information provided by their relative. Daily records referred to dentures, but this need was not included in the person’s care plan. Some people and relatives had been involved in care planning remotely but had not seen the completed care plans. Care plans also lacked sufficient detail to guide staff in delivering personalised support and responding to changes in need.

People and relatives were positive about regular staff and said they knew people well, understood their routines and respected their preferences. Staff described tailoring support around people’s interests, communication needs, independence and choices. However, these positive practices were not consistently reflected in the written records. This reduced assurance that all staff, including relief staff, had accurate and sufficiently detailed information to provide consistent, person-centred care.

The provider did not always ensure continuity of care when people’s usual staff were unavailable. Records did not consistently demonstrate clear contingency arrangements to show how people would continue to receive safe and consistent care during periods when regular support was unavailable. This meant the provider could not always demonstrate how people’s needs would continue to be met if usual care arrangements changed or unexpected events occurred.

Where contingency arrangements were not clearly documented, there was a risk that support could be delivered inconsistently. The lack of robust arrangements meant staff may not always have access to the information needed to ensure continuity of care during changing circumstances.

People and relatives were positive about the support they received from their regular carers and described trusting relationships that had developed over time. Feedback indicated regular staff knew people well and understood their needs and preferences. One relative told us they were, “Very happy” with the support provided by their regular carer. However, some relatives reported that experiences could differ when relief staff provided support, reinforcing the importance of clear contingency arrangements to maintain continuity of care.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff had access to care information through the provider's electronic systems and described reviewing care records and handover information to support people safely.

However, information available to people, relatives and staff was not always complete, accurate or consistent. Some people and relatives told us they had not seen care plans or copies of important records relating to their care. Records reviewed contained inaccuracies and omissions, including information relating to people's needs and support arrangements. This reduced assurance people, relatives and staff always had access to complete and up-to-date information.

The provider listened to people and understood their needs, views and wishes. People were involved in decisions about their care and support and were supported to make choices about how they lived their lives.

People told us staff treated them with respect and involved them in day-to-day decisions. One person told us staff always asked for consent before providing support and helped them choose their clothing and maintain their preferred routines. They said staff respected their privacy and dignity and never rushed them. Another person’s relative told us the regular live-in carer had developed a positive and trusting relationship with their family member and understood their needs well.

Staff demonstrated an understanding of the importance of involving people in decisions about their care. Staff described how they sought consent before providing support, offered people meaningful choices and respected decisions when people declined support. They could explain how they would adapt their approach to support people to make decisions and maintain as much independence as possible.

People and relatives knew how to raise concerns and told us they felt comfortable doing so. Feedback showed the provider responded when concerns were raised. One relative described how a concern regarding a relief carer had been rectified “promptly”.

However, records did not always demonstrate how people’s views, involvement and consent had been formally captured. One relative told us they had not seen a copy of their family member’s care plan, and records reviewed did not consistently evidence how people had been involved in care planning and review processes.

The provider supported people to access the care, support and treatment they needed in ways that reflected their individual needs and preferences. Staff described adapting how they communicated information to meet people's sensory and communication needs, including explaining information clearly, allowing additional time for responses and using approaches that helped people understand choices and participate in decisions about their care. People and relatives gave positive feedback about the support they received and did not raise concerns about barriers to accessing care. Staff demonstrated a good understanding of people's individual circumstances and described adjusting their approach to promote involvement, choice and independence. Although we identified some inaccuracies and omissions within care records, the evidence reviewed showed staff generally understood people's needs and provided support that respected what was important to them. People and relatives consistently told us staff knew them well and adapted support accordingly.

People and relatives consistently provided positive feedback about the support they received. They described staff as caring, respectful and responsive to their individual needs and preferences. People told us they felt safe, valued and supported by staff who knew them well and understood what was important to them.

Staff demonstrated an understanding of people's diverse needs and described adapting their support to promote independence, dignity, choice and inclusion. Examples included tailoring communication approaches, recognising personal preferences, and supporting people to maintain interests, relationships and aspects of daily life that were important to them. People's feedback indicated they were generally receiving support that reflected their individual needs and circumstances. People described positive relationships with staff and told us they felt respected, listened to and supported in a way that reflected their preferences and individual circumstances. Relatives also spoke positively about the quality of support people received.

People could not always be assured that planning arrangements would support them consistently when circumstances changed. Records reviewed did not always demonstrate how foreseeable changes in people's needs, emergencies or disruptions to usual support arrangements would be managed. We found examples where contingency arrangements, emergency planning and risk management processes had not been clearly established or documented. This meant the provider could not always demonstrate how people would continue to receive safe, responsive support in changing circumstances.

The lack of robust future planning increased the risk of disruption to people's care if needs changed, emergencies arose or usual support arrangements could not be maintained. Some planning arrangements and associated risk assessments were developed following inspection feedback rather than being fully established beforehand.

Following feedback, the provider took action to strengthen planning and oversight arrangements. This included developing additional contingency planning tools, risk assessments, governance processes and service improvement plans designed to improve future planning and service resilience.