LJM - Homecare Lincoln

On this page

• 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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 75 (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 clear vision and values which focused on providing person centred care and improving people’s experiences. The registered managers were enthusiastic about developing the service.

The provider’s values and priorities were shared through staff meetings, induction and training. Staff understood these values and described an approach based on providing the standard of care they would want for their own family member. People generally spoke positively about their care. One person said, "I think they do a great job."

Some staff and people felt these values were not consistently demonstrated by all staff. Concerns included how some staff communicated with people and whether they fully understood people’s individual expectations. The provider had systems for people and staff to speak up and raise concerns. Further work was needed to ensure these were consistently effective in identifying where practice did not reflect the culture and values expected by the provider.

The registered managers were knowledgeable, approachable and generally demonstrated the skills and values needed to lead the service effectively. The registered managers knew people well and understood their individual needs and the challenges facing the service. Staff and people generally spoke positively about their support, particularly when people or staff were experiencing difficult circumstances.

The registered managers considered staff wellbeing and made adjustments where health needs affected their work, although records of support and signposting were not always clear. People generally felt able to approach the registered managers. One person said, "Yes, absolutely I can." A professional health worker said, “Based on my experience of working with LJM Homecare Lincoln, I have found them to be committed to delivering good-quality care and support, with a focus on promoting individuals' wellbeing, choice, and independence."

The registered managers promoted people’s rights, choices and independence. There were positive examples where they advocated for people’s wishes and supported them to maintain independence and remain part of their community.

The provider did not always ensure people and staff felt confident that when they spoke up their concerns would be heard and acted on. People could provide feedback through care reviews, surveys and the Voice of LJM initiative. Staff could raise concerns through supervision, team meetings and other reporting systems. However, although there were systems for people and staff to speak up, these were not always effective in ensuring everyone felt confident that their voice would be heard or lead to improvement. Some staff said they received limited feedback after raising concerns and did not always know what action had been taken. One staff member felt discouraged from raising a concern again.

A small number of people also felt they had to repeatedly raise issues before changes were made. One person said, "To be honest I don't say anything now." They explained they were worried that continuing to complain could affect their care.

The provider valued diversity within its workforce and had systems to support an inclusive and fair working environment. Policies supported equality and inclusion and the provider employed staff from a range of backgrounds. Some feedback about overseas staff appeared influenced by prejudice and stereotyping. The provider needed to challenge this while also recognising that some people had identified genuine concerns about communication and understanding of individual care needs. There were also positive examples of relationships developing between people and staff from different backgrounds. One person described how staff had learnt to prepare food they enjoyed and later shared food from their own culture with them which had been greatly appreciated.

The provider supported staff through induction and training. Further support around local language, culture and social expectations would help staff develop their confidence and ensure people received consistent care.

The provider had effective governance systems to oversee the quality and safety of the service.

There were extensive auditing and monitoring systems. A detailed contact log recorded communication, actions and outcomes, helping the registered managers maintain oversight of people’s care.

The provider was using artificial intelligence (AI) tools alongside human oversight to analyse information and identify issues that may otherwise be missed. However, some governance information was complex and could make recurring themes less clear. We discussed making records more concise to strengthen oversight of issues such as complaints, communication and continuity of staff.

Governance systems considered people’s individual needs and outcomes. The provider continued to develop its systems to improve oversight and support sustainable, person centred care.

The provider worked well with other organisations and community partners to improve people’s care and outcomes. The provider worked closely with healthcare professionals, local authorities and community organisations. Information and learning were shared to help people receive joined up support and overcome barriers to achieving positive outcomes.

There were strong examples of partnership working making a difference to people’s lives. This included working with other agencies to help people remain safely at home, improve their wellbeing and increase opportunities to access their community. Professionals also gave positive feedback about working with the service. One professional said, "I have found the service to be professional, responsive, and person-centred in its approach. Staff have consistently demonstrated a good understanding of individuals' needs and have been able to provide a wide range of support, including personal care, social inclusion, assistive technology, and promoting independence. The service has shown flexibility in meeting changing needs and has been able to implement support packages in a timely manner.”

The provider demonstrated an outstanding commitment to learning, innovation and research, using new approaches to improve people’s safety, wellbeing and quality of life. They worked with research groups and trialled technology aimed at preventing falls and pressure damage. AI was used with human oversight to analyse daily care records and identify early changes in people’s health and wellbeing. An AI assessment tool was also being trialled to support assessments and identify areas of risk.

Virtual reality had been trialled with people living with dementia, enabling them to revisit places that were meaningful to them but which they could no longer physically access. Feedback showed this had a positive impact on people’s wellbeing and the local authority planned to continue its use as a result of the trial.

Staff had access to a purpose built training room where they could practice clinical skills using realistic equipment, including equipment used by people receiving care. Relatives were also invited to training so they could safely support family members with areas such as PEG care, stoma care and medicines. A PEG (percutaneous endoscopic gastrostomy) is a feeding tube placed directly into a person’s stomach to provide nutrition, fluids or medicines when these cannot be taken safely or adequately by mouth. A stoma is a surgically created opening on the abdomen that allows waste from the bowel or bladder to leave the body into a collection bag.

Staff were encouraged to gain further qualifications and the registered managers shared learning gained through networking and conferences. The provider had also received awards recognising its innovation and excellence. The Voice of LJM initiative gave people further opportunities to contribute to developments within the service.

The provider continued to explore how the impact of innovation could be more clearly measured to demonstrate the difference it made to people.