Livingways Care Services Ltd (Carlisle)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed. Some care plans contained contradictory information and lacked sufficient detail about how to support people to ensure their needs were met in a safe and consistent manner.

For example, one person needed support with mobility and the care plan stated to ‘use safe moving and handling techniques’ but did not detail what techniques these were. Another person’s care plan said they needed, ‘support with personal care including showering, washing, drying.’ There was limited detail in relation to how the person preferred to be supported.

This was shared with the registered manager who took immediate action to review care plans and learn lessons.

Other care plans contained detailed information on people’s needs and their preferences for how they wanted to be supported.

The provider planned and delivered people’s care and treatment with them. They did not always fully implement current evidence-based good practice and standards.

The electronic care planning system included clinical tools such as MUST and Waterlow to assess people’s nutrition and hydration needs, and their skin integrity. Some care plans were detailed in relation to people’s nutritional needs. One stated, ‘Where required, staff must record fluid intake using daily fluid charts.’ There was no detail on when this would be required. The branch manager said, “We would use food and fluid charts where it was assessed that people were at risk.”

In response to our findings the registered manager said they would complete a review of care records to make sure it was clear if food and fluid monitoring was required.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they worked well as a team and said there was effective communication through electronic systems, phone calls and team updates to ensure continuity of care.

The registered manager told us they were happy to challenge other professionals involved in people’s care if they felt there was insufficient time to meet people’s needs, or if they felt people’s needs had changed.

There were some challenges to working with people and other professionals in relation to language barriers. The registered manager told us. “There are some cultural differences in communication styles which are being addressed."

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff told us they understood people’s health needs and followed care plans to support them safely. They described monitoring people’s wellbeing during visits and reporting concerns promptly. One staff member said, “I ensure the person is safe first, seek medical help if needed, and report it immediately to my manager.”

Following medical emergencies or falls lessons learned were discussed in team meetings to ensure staff had the opportunity to reflect, and if relevant learn from how staff had managed incidents.

The provider routinely monitored people’s care and treatment to continuously improve it.

The branch manager explained regular review meetings were held to make sure people’s care was meeting their needs. They also said, “I do a weekly check to monitor and make sure things are on track. If concerns are raised about people’s health, I would ring the GP or social worker immediately.”

Staff described clear systems for reporting any concerns.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff told us they involved people in decisions around their care. One staff member said, “I always speak with people, listen to their preferences, and respect their choices.” Staff understood the Mental Capacity Act and how to balance choice and risk. One staff member told us, “If someone chooses to take a risk, I follow the Mental Capacity Act principles and work with them to reduce the risk while still respecting their rights.” Staff also described asking for consent before providing care and maintaining people’s privacy and dignity.