Livingways Care Services Ltd (Carlisle)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

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

This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff reported concerns about safety events and accidents and incidents were logged. Incidents were analysed for themes and trends and lessons learnt to identify and embed good practice.

A staff member said, “If an incident or accident happens, I report it straight away to the office or my manager. I then complete an incident report form with full details of what happened, who was involved, and any actions taken. Incidents are taken seriously and investigated properly. My manager usually follows up by speaking to staff involved and reviewing what happened to understand the cause and prevent its recurrence. After an incident, I usually have a discussion with my manager where we talk through what happened. This helps me reflect, learn, and feel supported."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and relatives gave positive feedback about continuity of care during hospital discharge and changes in care needs. One relative said, “(Person) is safe with them and it’s meant they could stay at home but with support we are now trialling a care home.”

A staff member said, “When supporting someone new, I usually receive a care plan in advance and have a shadow shift where I go with an experienced staff member to understand the service user’s needs and routine."

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

People and relatives told us they felt safe and that staff acted appropriately when risks arose. Staff understood safeguarding procedures and were able to explain how to raise a concern. Logs of safeguarding incidents were documented, alongside referrals and investigations. Action was taken to learn and minimise the risks of recurrence.

People and relatives told us staff involved them in discussions about risks although this was not always clearly recorded in care notes. Risks in relation to falls and choking were assessed and action taken to manage the risks. The use of paraffin-based creams by some people had not been robustly assessed. The registered manager took immediate action to address this.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risk assessments were in place. Concerns in relation to equipment were appropriately reported and acted on.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Safe recruitment practices were in place. Staff received induction, mandatory training and supervision. A staff member said, “I completed a structured induction including shadow shifts and training. Managers are approachable and provide guidance when needed.”

People and relatives praised many staff for being competent and responsive. However, several relatives reported frequent changes of carers. This was shared with the registered manager who said they would explore this further.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff completed infection prevention and control training. Regular spot checks were completed which included an assessment of IPC practices and PPE use where appropriate.

Medicines were administered safely, but we identified shortfalls in some records.

Some care plans and Medicine Administration Records (MARs) contained contradictory information, in relation to areas such as insulin use and blood glucose monitoring. There had been no impact on people due to this. For some people who were prescribed creams there was limited information on where to apply creams. The registered manager took prompt action to address this. They confirmed improvements had been made and records updated to ensure they were accurate and up to date.

Protocols for as required medicines were in place. People and relatives described staff as “careful with medicines” and said any errors were acted on quickly. Staff demonstrated good knowledge of medicine refusals and a staff member said, “If someone refuses medication, I respect their choice, record it and report it to the office."