Livingways Care Services Ltd (Carlisle)

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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 for this newly registered service. This key question has been rated 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 made sure people were at the centre of their care and treatment choices. They worked in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People and their relatives told us they were involved in decisions about their care and that staff understood their preferences. One person said, “Recently we needed a time change and the carer and I arranged it together, it was a joint decision.”

Staff described how they involved people in decisions and respected their choices. One staff member told us, “I always speak with the service users, listen to their preferences, and respect their choices. I encourage them to be involved in decisions and explain risks in a way they understand.” Staff said care plans usually gave them enough guidance to provide personalised care.

There were some shortfalls in the continuity of care provision, particularly where people received support from multiple care staff.

Some people and relatives told us they had regular carers and valued this. One person said, “I do know my carers mostly or at least one of them, and that’s really nice.” Others told us care was affected due to a lack of continuity with staff. One relative said, “We need more continuity of care. Different people every time and I have to show them everything.” Another relative described concerns about moving and handling when carers were unfamiliar with the person’s needs. The registered manager agreed to look into these concerns. They explained that sometimes, due to circumstances outside of their control, changes had to be made to some visits.

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

People and relatives told us they could contact the office easily and were kept informed. One relative said, “It’s always easy to get hold of the office, they answer the phone straight away.”

Staff said changes to care plans or visit times were communicated clearly, including through the electronic care system. One staff member told us they were informed of changes, “through email or updates on the electronic care system, and sometimes the office will call.”

Information was not readily available in different formats. The registered manager told us if people needed information in different formats, it would be provided.

The provider 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.

People told us they felt able to raise concerns and that issues were addressed. One relative said, “There have been some minor issues, but they deal with them straight away.”

Staff confirmed people and relatives were involved in reviews and decision‑making. One staff member told us, “People using the service and their relatives are encouraged to share their views, and this feedback is used to update care plans.” Staff said they felt confident to speak up and that learning from incidents was shared.

Concerns and complaints were recorded, investigated and appropriate action taken, including learning lessons.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Care plans considered people’s needs and preferences and records indicated care and support was provided at the times people had requested.

Emergency and out of hours protocols were in place to ensure people received appropriate support should there be circumstances where staff were running late or not available.

People did not always experience equitable outcomes, particularly where communication and continuity of care were inconsistent.

Some people and relatives told us language differences could make communication difficult. One relative said, “With some of the carers there is a difficulty understanding them, they try to chat but (relative) doesn’t always understand them.”

Where people had specific conditions, relatives told us they thought staff knowledge was not always sufficient. One relative said, “Because we have different carers, they often don’t understand their needs.”

This was discussed with the registered manager who said they were trying to address communication issues by looking at English language courses. They also said they would review specialised training and arrange refresher courses.

People were not always supported to plan for important life changes, including at the end of their life.

The registered manager told us they were not currently supporting anyone who was nearing the end of life. They said, “Discussions have taken place with people, but some people don’t want to talk about end-of-life care.” There was no evidence these conversations were recorded, and end-of-life care plans were not in place. This meant it was not clear how people’s wishes, preferences, or decisions about future planning and end-of-life care were recorded, reviewed, or shared with staff.

As a result, staff may not always have clear guidance on how to support people sensitively and in line with their wishes as their needs change or at the end of their life.