Archived: Living Glory Social Care

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 requires improvement. At this assessment the rating has changed to inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in continued breach of legal regulations in relation to the need for consent.

This service scored 29 (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 did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

The provider did not always work with people, relatives and professionals to ensure needs were assessed, understood and regularly reviewed. People had risk assessments and care plans which were not always updated when their needs changed.

Relatives told us they were involved in initial assessments of their loved one’s needs, but as people’s needs have changed, the care plans have not been changed to reflect this. A relative told us, “They don’t contact me with any updates. We get a call for a phone review of how the service is going, but nothing else”.

People’s current health conditions were listed but there was no information made available to staff on how these affected their care, and what to do in situations where action may be required. It is important to document how health conditions affect people so they can receive the appropriate care in line with their assessed needs.

People and relatives told us their care needs had not been reassessed since the care calls with the provider commenced, over 2 years earlier in some cases.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Whilst many people and their relatives told us they had been asked for feedback on their care, the provider’s processes for ensuring people were consistently involved in their care planning and the information recorded in support plans was accurate, were not effective. Important information about people’s care and support needs had been omitted from some support plans.

The provider continued to not complete Mental Capacity Act (MCA) assessments for people using the service that may lack capacity to make decisions for themselves about their care and so need others to do so in their best interests.

People’s wishes and preferences had not been consistently documented within their care plans. These care plans did not capture how each person preferred to receive care. The missing personalised detail in the care plans showed the provider was not actively working to deliver care in line with Right Support, Right Care, Right Culture (RSRCRC).

Records and staff rotas demonstrated that people did not consistently receive their care calls for the agreed duration of time or at the correct time to meet their support needs. Some people and relatives told us they regularly experienced late calls from different staff. However, many people told us they were happy with the call times including the length of time staff were there. The provider failed to operate a robust system to monitor for short, late or missed calls. They told us that if a staff member had not attended, the scheduling system would let them know and person would be contacted, or replacement staff would be allocated to the visit. However, we found this not to be the case and found evidence of multiple missed calls for numerous people. This did not reflect a robust or effective system as staff delegated to monitor late and missed calls had failed to do so effectively. This placed people at risk of unmet care needs.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The provider did not hold regular minuted staff team meetings or supervisions. This meant there were missed opportunities where areas of concern, or positive feedback could be discussed as a group, or on an individual basis.

Not all people knew who the registered manager was. This meant people may not know who they should speak to if they have concerns or would like to discuss their care. Some people identified different office staff as the manager.

There was positive feedback from people and relatives about the staff. One relative told us, “They [staff] are all really friendly and caring.”. However, negative feedback was received from people and relatives regarding the support offered by office staff. One relative told us, “I stopped calling the office because they don’t listen.” Another told us, “It’s really difficult getting anyone to answer the phone when I call.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The provider’s system and processes to ensure care records and risk assessments reflected the support needs of people were ineffective. This meant staff did not always have the correct guidance on how to support people appropriately to manage their health and wellbeing, whilst encouraging independence.

Staff could tell us how they would contact the office staff to access additional support from healthcare professionals to help people manage their health, should this be required.

People told us they were able to make choices and decisions about what they would like to eat and drink during care calls. Those that had support to access the community in their care plans, told us this usually took place as planned.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Outcomes- based support plans had not been developed for people with long term health conditions. This meant they could not evidence how people’s outcomes would be improved.

The provider did not record or investigate all complaints received. The complaints that had been logged, were showing as being investigated, and listed follow up actions; however, this process was not robust. The provider was unable to evidence investigations had taken place or that staff and other people had been included in the investigation process. We saw the follow up instructions had not always been implemented or followed up on. There was no robust analysis of such complaints to identify themes and trends. This meant opportunities had been missed to use feedback and concerns to help drive improvements across the service.

We saw staff supervisions had taken place; however, this was 6- monthly, and not in line with company policy. There was no system for tracking supervisions, and the provider was unable to demonstrate all staff had received supervisions. This meant staff had not always been provided with an opportunity to discuss any concerns they may have about people’s care or how it could be improved. We found continuing problems with staff annual appraisals, as these were not being completed.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

The provider still was not compliant with the Mental Capacity Act (MCA) 2005. The provider had not consistently obtained evidence that those making decisions on people’s behalf had the necessary legal authority to do so. This meant the provider could not assure themselves people were being supported in the least restrictive way and decisions were being made on their behalf appropriately.

The provider told us all people currently using the service had capacity to make decisions about their care; however, feedback from a relative confirmed this was not the case. Relatives were making decisions for people in relation to their care on a day-to-day basis without any related information or guidance on this having been recorded in people’s care plans. The manager and staff members we spoke with did not demonstrate a clear understanding and consistent application of the MCA. They were not adhering to current requirements in relation to the MCA, Deprivation of Liberty Safeguards (DoLS) and best interests decisions.