LJM - Homecare Lincoln

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 requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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 put people at the centre of their care and generally provided support around their individual needs, preferences and choices. Care plans contained detailed information about what mattered to people and how they wanted their care provided. One person with complex health needs had previously been refused support or given notice by other providers. Their anxiety meant small changes to established routines could significantly affect their wellbeing. The person and their family developed their own detailed care plan, including photographs showing how they wanted support provided. This covered their daily routines, medicines and complex healthcare needs. Staff used this information alongside risk assessments and had successfully supported the person for over a year.

Most people felt their preferences were respected. One person said, "They're just really good, the good ones are brilliant and I can’t fault them, they ask me what I want and make me feel comfortable." Some people felt this was less consistent when unfamiliar staff supported them. Concerns included staff not understanding equipment or how people preferred food and drinks to be prepared. The registered managers were addressing this and further training for staff was planned.

The provider worked with other services to provide joined up care and support continuity for people. People received support from a range of care staff and health and social care professionals. The provider shared information with other services when people’s needs changed to help maintain consistent care. Professionals gave positive feedback about joint working.

Staff worked with other professionals to help overcome barriers to care, including where people had complex health needs or required specialist equipment. One professional said, “Communication has been effective and constructive. The management team has been approachable and responsive, particularly when working collaboratively on more complex cases. Information is shared appropriately, concerns are raised promptly, and there is a clear willingness to work in partnership to achieve positive outcomes for individuals.” A relative told us, "They keep [my family member] safe and look after them and are always by their side."

The provider provided information in ways that supported people to understand their care and make choices. Systems were in place to share information with people and staff. The provider had worked with the Deafblind Society to improve how people’s communication and safety needs were understood. Staff used communication aids, including flash cards, where needed to help people express their choices and preferences.

However, some information such as policies and documents explaining about provider speaking up groups was lengthy or complex, which risked making it difficult for people and staff to understand or retain. People gave mixed feedback abouts care visit scheduling information. Some people said it was not always provided consistently and they had to contact the office to find out who was supporting them. Other people told us, staff rang them weekly to tell them who was supporting them for that week.

The provider did not always ensure people felt listened to or that concerns and complaints resulted in timely and effective improvements.

People had opportunities to give feedback and most feedback received by the provider was positive. Staff considered people’s communication needs and used aids such as flash cards where needed. There was a complaints process and the registered managers responded to complaints.

Concerns were also raised about communication with some office staff. Some people said they had to raise concerns more than once before changes were made and improvements were not always sustained. One person said, "[Staff] didn't listen to me about the calls." Other people described more positive responses when they raised concerns, showing experiences were inconsistent. One person said, "I have made about 3 complaints and I can’t remember what they were, they sort it out more or less straight away."

Not all people knew who held responsibility for managing the service, which could make it less clear who they could approach if they remained unhappy with the response to their concerns.

The provider supported people to access the care and health services they needed and worked to overcome barriers to receiving appropriate support. Staff worked with health and social care professionals when people needed additional support or specialist input. Care planning considered people’s health conditions, mobility and communication needs so reasonable adjustments could be made where required.

There were examples of the provider supporting people with complex needs who had experienced difficulties accessing suitable care from other services. Staff worked with other professionals to help people receive support safely in their own homes.

People generally felt staff supported them to access help when needed. One person said, "They are good at getting the medical support." Staff understood that people could experience different barriers to accessing care and worked with them and other services to reduce these where possible.

The provider did not always ensure people had consistently positive experiences and outcomes that reflected their individual needs and circumstances. Although there were examples where care was very personalised around people’s diverse needs and preferences. The provider worked with health professionals and other agencies to help people overcome barriers to accessing healthcare and community opportunities. However, some people felt their experience depended on which staff supported them. Differences in communication, understanding of people’s preferences and familiarity with their routines sometimes affected the support they received.

The provider needed to strengthen how it identified and responded to inequalities in people’s experiences and ensure all staff understood how to support people’s individual needs consistently.

The provider supported people to plan for changes in their lives and make informed decisions about their future care, including care at the end of their life. Care records included future and end of life planning and families were involved where appropriate. Relatives gave particularly positive feedback about compassionate end of life care and the support provided to families. One relative said, "They were really exceptionally good to [my family member] as they were very poorly and I wouldn’t let them go into hospital."

There was a particularly positive outcome for one person who began receiving end of life care. The person had the mental capacity to decide about their care and treatment and wished to continue receiving all care measures. Staff advocated for their wishes and continued to support their choice. Their health later improved and they no longer required end of life care. With support from staff and physiotherapy, the person also regained some mobility and independence.