Archived: Lancashire Domiciliary Care Service

On this page

• 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (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 and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff were trained in person centred care, and care plans detailed people’s physical, mental, emotional and social needs. We observed people receiving different levels of support, based on individual needs and preferences.

Relatives confirmed they were involved in decision making when people’s needs changed. A relative said, “The service listened to us and took our opinions into considerations.” Another added, “Staff inform us of any problems or changes. We as a family are totally involved.”

Bedrooms were generally personalised, though some communal areas lacked personalisation and homely touches. Following feedback, the registered manager agreed to discuss the décor with the housing association.

The provider understood the diverse health and care needs of people with learning disabilities and autism, so care was joined-up, flexible and supported choice and continuity.

Staff received training in topics including autism awareness, dementia, down syndrome and the Oliver McGowan learning disability training to enhance their understanding of the people they supported.

Many staff had worked at the service for several years, providing consistency and continuity of care. A relative said, “All staff who get to know [person], gets to know them well. Two staff who care for [person] have been with them in their property for 10 years. Wherever possible, the staffing structure remains the same.”

Some relatives commented on the use of agency staff, though the registered manager explained new initiatives to improve morale and reduce turnover. This was reflected in feedback from a relative who told us, “In the last 18 months I feel there is less use of agency and bank staff. I think it is being managed really well.”

The provider lacked systems to track 1 to 1 support people in shared tenancies received. Following feedback, the registered manager reviewed staff rotas to ensure the level of support could be better recorded and monitored.

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

The provider met the Accessible Information Standard (AIS) by identifying, recording and meeting people’s communication needs. Easy read documents were available, and people’s communication needs were detailed in care plans. The service worked with learning disability nurses to develop communication passports if required.

Staff communicated with people in a way they could understand and were knowledgeable about the meaning of gestures, behaviours, facial expressions and signs.

Staff were trained in the General Data Protection Regulations (GDPR) and cyber security, and people’s information was stored securely on the electronic care planning system.

The provider enabled people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People were supported to join a self advocacy group, which helped make decisions about the service. The group contributed to easy read policies, met regularly to share ideas and were involved in driving improvements. For example, they had requested rescue goats for the animal care provision and were involved in the design and construction of their pen. The enclosure was regularly enjoyed by people supported by Lancashire Domiciliary Care Services.

The provider held regular meetings within individual homes to gather feedback and address concerns, and annual surveys were sent out to people and their relatives.

Relatives met quarterly, and detailed minutes showed they were kept informed about upcoming changes, with their feedback shared with managers and the provider. Meetings were used to demonstrate the electronic care planning system, explain how people’s money would be managed, outline management changes, discuss initiatives to support staff morale and other developments at Lisieux Hall.

The provider had a robust complaints process, with information available in an easy read compliments and complaints policy. A relative told us, “We are sure that any complaints would be taken seriously and investigated.” Where concerns were raised about the safety and quality of care, the service worked closely with the local authority and relevant legal representatives to resolve these.

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

The provider ensured people had the necessary aids and adaptations, so their homes were fully accessible before they moved in or if their needs changed. We saw hoists, specialist beds and chairs in place if required. One person who moved around on the floor had a daybed in the hallway so they could rest when they became tired.

Support was flexible to enable visits to relatives, changes to activities and to attend healthcare appointments. A relative told us, “We have always found [Lancashire Domiciliary Care Services] willing to be flexible around [person’s] support needs.”

The registered manager explained out of hours arrangements to ensure managerial support was always available.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff received equality and diversity training and were given the Skills for Care Code of Conduct during induction; which outlined expectations to respect diversity, promote equal opportunities and report discrimination.

The registered manager described several occasions where they had advocated for additional funding or support when people’s needs changed, to improve their experience or outcomes.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider did not always ensure people were involved in decisions about their future care or record people’s end of life wishes. One person had suffered from clinical deterioration; the hospice had been involved and a ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) was in place. However, details of their end of life wishes and agreed support had not been included in their care plan.

Staff gave examples of people being supported to achieve future goals and ambitions, including learning new skills, securing jobs or improving fitness. A staff member told us, “Staff have a chat with people about long term and short-term outcomes. [Person] wants to plan going to a rugby game and have staff available. The cafes opening soon and they are interested in doing a food safety course and volunteering. [Person] also attended a 6 week Makaton course because they were interested in that.”

Following feedback, the registered manager assured us people’s end of life wishes would be reviewed and recorded in their care plan.