LJM - Homecare Lincoln

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. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 assessed people’s health, care and communication needs with them so care reflected what mattered to each person.

Assessments and care plans were detailed and reflected people’s preferences, routines and health needs. Staff understood people’s individual needs and people were involved in decisions about their care. One person said, "We always talk, and that’s what I like."

There were examples of particularly detailed planning where people had complex needs. One person’s care plan described how anxiety affected them and gave staff clear guidance about how they wanted their support provided. This helped staff understand the person and reduce situations which could cause distress.

A small number of staff said assessments were not always completed promptly which meant important documents for new people were not always available for staff to access when they needed them. This could make it more difficult for staff unfamiliar with that person to understand their needs from the start.

The provider planned and delivered care in line with good practice and what was important to people. Good practice guidance was used, particularly for people with complex healthcare needs. Training was practical and helped staff understand why clinical tasks and medicines support needed to be provided in particular ways. A dementia bus experience for staff was used to help staff understand how people living with dementia may experience their surroundings.

People generally felt staff had the knowledge needed to support them. One relative said, "They have dementia training and hoist training."

The provider worked with health and social care professionals where specialist advice or support was needed.

The provider worked well with other services to support continuity of care and meet people’s individual needs and

People’s care plans recorded their individual needs and preferences.

The provider worked with health and social care professionals and maintained a detailed contact log. This recorded communication, actions required and whether these had been completed. This supported oversight when people’s health changed, equipment was needed or people moved between services.

The provider was subcontracted by 3 other care agencies and shared updates and information with them to support people’s care. A professional said, “Throughout our working relationship, LJM have generally demonstrated a positive approach to partnership working and collaborative communication. Day-to-day communication regarding service delivery is typically timely and constructive, and where queries or concerns have arisen, these have been addressed through open discussion between both organisations. In instances where operational challenges have been identified within jointly supported care packages, LJM have engaged appropriately in discussions relating to care delivery, risk management, and service continuity. They have also participated in reviews and planning discussions to help ensure individuals continue to receive safe and effective care.”

Many relatives felt involved and informed. One relative said, "I have a good liaison between the office and myself and they know I speak my mind. They are very understanding and will sort things out with the staff. They are really doing a good job of caring for [my family member]."

The provider supported people to manage their health and wellbeing and maintain their independence. Staff understood people’s health conditions and care plans guided them about signs of deterioration and when to seek additional support. Staff worked with healthcare professionals and responded to changes in people’s physical and emotional wellbeing.

There were positive examples where support had improved people’s health and reduced their reliance on care. One person who had previously needed 2 staff members and a hoist for transfers improved their mobility alongside physiotherapy and support from staff. Their care reduced to support from 1 staff member only as their independence improved.

The provider did not always monitor people’s care effectively enough to ensure improvements resulted in consistently positive outcomes.

There were many examples where people had achieved positive outcomes, including improved health and greater independence. Care reviews, feedback and complaints were used to understand people’s experiences and identify where changes were needed. However, some people felt concerns did not always result in sustained improvements and issues sometimes had to be raised more than once. One person said, "Sometimes I think it goes in one ear and out the other with the office staff."

People were involved in reviewing their care, but the provider could strengthen how people’s individual goals and aspirations were identified and monitored to show whether these were being achieved over time.

Processes were in place to seek and record consent and support people to make their own decisions. Most people told us staff sought their agreement before providing care. One person said, "Yes, they always ask." Some records were not immediately clear about the authority relatives had when signing documents on behalf of people who had capacity to make these decisions themselves. The provider needed to ensure records clearly reflected people’s rights and who was authorised to make decisions on their behalf.

Care records included information about people’s communication needs to help staff understand how they expressed their choices. This included creating picture cards to support a person who did not communicate verbally.