Livingways Care Services Ltd (Carlisle)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 68 (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 shared vision, strategy and culture. There was a focus on delivering compassionate care and promoting people’s independence and wellbeing. Staff understood these values and described a positive culture where people, relatives and staff felt listened to and respected. Staff feedback consistently reflected the aim to provide safe, high‑quality care and treat people as individuals, and this aligned with what people and relatives told us about their experiences of care

There was a culture where concerns were generally addressed promptly. Some relatives raised concerns about continuity of care and communication difficulties linked to staff changes and language barriers. This was being addressed by the registered manager.

The provider understood the context in which they delivered care, and support. They had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders were visible, and responsive. People, relatives and staff consistently told us the registered manager and office staff were easy to contact and acted quickly to resolve queries or concerns. Staff described managers as supportive and said they felt listened to and valued.

Staff demonstrated compassion and commitment to people’s wellbeing. For example, by responding promptly to incidents and working with health professionals when people’s health deteriorated.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they felt confident to raise concerns and understood how to report incidents, safeguarding issues and poor practice. They described clear processes for incident reporting and said learning was shared through supervision, discussions and team updates. Staff also demonstrated a good understanding of whistleblowing and their responsibility to keep people safe.

Where concerns were raised, these were acted upon promptly, such as changing staff or addressing care issues.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had policies in place to promote equality and inclusion, and staff spoke positively about working in a supportive and inclusive environment. Leaders acknowledged challenges linked to local recruitment and the impact of language differences on people’s experiences. The registered manager told us they were exploring additional support, such as English language training, to address these issues.

The provider did not always have clear systems of accountability or good governance.

The provider had governance systems in place, including audits, service improvement plans and quality monitoring tools. Data from the electronic care planning system and medicines audits were used to identify issues. Action was taken when concerns were highlighted.

However, governance systems were not always effective in identifying risks proactively. We identified inconsistencies and contradictions in some care plans and medicine records that had not been detected through routine audits. These concerns were not widespread and had not impacted the care people received. Service improvement plans and incident analyses were not consistently dated or clearly tracked, making it difficult to assess progress and sustainability.

The registered manager said, “Since feedback we have strengthened our quality assurance systems by introducing more detailed care plan audits to ensure greater clarity, consistency and oversight.”

The new systems needed to be fully embedded and consistently maintained to ensure the required improvements were achieved and sustained.

The provider understood their duty to collaborate and work in partnership.

The provider worked with external professionals, including GPs, pharmacists, social workers and emergency services, to support people’s health and wellbeing. People and relatives gave examples of staff acting promptly to seek medical advice or emergency support when needed. Staff also described effective communication with health professionals when people’s needs changed.

The registered manager and the branch manager acknowledged some challenges in communication with external partners. While partnerships were generally effective, the registered manager confirmed that improvements were needed to ensure collaboration was consistently embedded.

The provider demonstrated a willingness to learn and improve.

Several improvements to audits, care planning and governance systems were implemented in response to inspection findings rather than being identified through routine monitoring. This showed that whilst the registered manager was committed to improvement, learning was not yet fully embedded or sustained across the service. The registered manager took immediate action in response to inspection feedback and showed openness to challenge.

Staff described learning from incidents and said feedback from surveys, complaints and compliments was shared and used to inform changes. One staff member told us, “Lessons learned are shared so we can improve practice.” This helped staff reflect and improve the quality and safety of care.