Lav Care Services- East of Anglia

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

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.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Prior to our assessment we received a number of concerns regarding the behaviour of staff towards people who used the service.  We received mixed views from people regarding the kindness and approach of staff. People told us, “The staff are kind, I have not had any problems with them.” And, “I have had a rude carer who didn’t want to support me, and I asked him to leave. Management had words with them, and he didn’t come again.”

Staff were not always respectful of people’s dignity, as the language recorded by staff in people's daily notes was not always dignified.

The provider had not always ensured an open culture with other organisations and key partners .

Where people had expressed to the management team a dislike for having their care and support provided by certain members of staff, there was a lack of recorded evidence to show this had been investigated by the registered manager and people’s best interests considered.

People in receipt of care within a supported living environment told us they had limited access to activities. Although some people told us they had control of their support and their independence was encouraged, we found this was not always the case, and people were not always empowered to make decisions or choices about issues that were important to them. For example, those in supported living choice as to where they lived. We identified people who were moved from their current home at short notice in excess of 20 miles from where they currently lived without evidence of proper consultation.

The management teams verbal account of how people were supported did not always confirm they understood how to ensure people were always in control of their support and encouraged to be as independent as possible.

Stakeholders expressed concern with us as to the movement of people from one supported living location to another without assurances this was always in the best interests of people.

Where serious incidents had occurred where people had expressed distressed behaviour, we found people had been referred to by the management team as perpetrators.

The provider did not always ensure people’s care was planned in a way which put them in the centre of any arrangements and decisions made. When people could experience different triggers of distress and challenges in their day-to-day lives, the support strategies we were told were in place did not always promote people’s independence and wellbeing.

We received mixed feedback about how the provider was ensuring people had independence, choice and control over their care and support. Many people did not recall being involved in discussions about their care and had not seen their care plan and therefore no meaningful opportunity to be involved.

One person told us how their individuality was respected by staff, “They [staff] are very good and treat me as an individual.”

Some staff told us how they supported people’s independence. Comments from staff included, “We offer people choices whenever we can.” And “We always ask people what they want to do and what they need.” 

Whilst some people told us they had access electronically to their care plans others said they did not and had not been involved in planning their care and were not aware of any system to be involved in any review. We saw some care plans contained detailed information about people’s likes and dislikes, their preferred routines and how they wished to improve their independence.

The provider did not have a robust process for showing all people had been consulted in the planning and review of their care and support needs. This meant we could not be assured people always had full choice and control of their care, support and how this was to be delivered.

People told us they found the majority of staff approachable if they had concerns. However, people also told us there were staff they preferred not to have support them. One person told us, “They [staff] don’t really understand my needs as there is a language barrier because most of the staff are from overseas and don’t speak English very well.” Another said, “I can stand up for myself and make my views known.” 

One person told us, “I have had a rude carer who didn’t want to support me, and I asked him to leave. Management had words with them, and he didn’t come again.”

Staff and the registered manager did not demonstrate best practice around assessing mental capacity, supporting decision-making and best interest decision-making. This demonstrated an infringement of people’s human rights.

During our visit to a supported living service, we observed staff interacting with people in a caring, considerate manner.

Where incidents had occurred, records did not always show staff had carried out regular welfare checks on people to ensure their safety and if further intervention such as pain relief was needed. For example, checks to ensure they were not experiencing pain or discomfort from injuries.

Some staff were able to explain how they provided choice and promoted independence to people they cared for, showing an understanding of person-centred working. However, this was not always the case with care plans and details of people life stories not clearly evident.

The provider operated a Facebook social media page, which contained images of people they support. There was no evidence in people care plans to show people’s consent had been obtained.

Care reviews were not regularly undertaken to demonstrate people were involved in the review of their care and support.