Living Ambitions Limited - Essex

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 67 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to using the service. The provider had changed to an electronic system, and people’s needs were assessed regularly and updated when needed. The registered manager was aware some previous paper documents had been uploaded to the system which required more regular updates to ensure all information was accurate. The registered manager had a process in place for new admissions and told us, “We have a team of assessors going out to assess, the initial referral will come to me and the service manager.

We will determine if person is compatible. We will engage with families/person to organise a visit.”

Staff we spoke with at the various locations knew the people they supported very well. They told us key worker meetings were held regularly to review support plans and people’s goals. Staff were able to tell us of work they did supporting people to transition into the service.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were supported with their nutrition and hydration needs and spoke positively about the food and choices available. One person told us: “The food is nice; I like the porridge.” Another said: “I choose whatever I want for lunch.” A relative added: “[Person] helps to cook the food they like to eat.”

Staff told us they supported people to be involved in the preparation and cooking processes as much as they were able. A staff member said, “[Person] cuts up their own salad, and another person cooks for everyone 3 times a week, we just observe.”

As highlighted in the risk section, staff needed to ensure all parts of people’s support plans accurately reflected dietary needs. However, staff we spoke with demonstrated a good understanding of people’s individual requirements. People received timely support and advice from relevant professionals when needed, such as their GP, dietitian, or speech and language therapist (SALT). One person told us: “The dietitian has put me on a diet, I enjoy one treat a week. I go shopping myself with a carer.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. However, communication to relatives was not always consistent.

The service had systems in place to encourage communication, and senior staff were confident in referring people to other professionals when additional support was required. A staff member told us, “We have good relationships with other professionals and will put in referrals when needed.”

There was some mixed feedback from relatives about being kept informed. One relative said, “They support [person] to the dentist etc. They had to go to outpatients once and they supported [person] and informed the family.” Another relative told us, “We don’t get much information about what’s going on. Once [person] went into hospital and we didn’t even know about it.”

Improvements were needed to ensure paper documents, such as hospital passports and health action plans, were reviewed alongside electronic care planning information. While staff at locations updated these when requested, stronger oversight was required to prevent recurrence.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We found staff were supporting people across all locations to live healthier lives. In most locations, information about healthy diets was available to people, helping them make informed choices. At one location, the service went further by organising a healthy living workshop, which encouraged people to adopt positive lifestyle changes. A staff member told us: “We have supported one person to lose weight by eating healthier.”

People’s individual preferences and health needs were captured in their support plans. While some plans were detailed and comprehensive, others required further development to ensure consistency. The provider was aware of this and had plans in place to improve the quality of documentation. Staff we spoke with demonstrated a clear understanding of how to meet people’s individual needs and supported them in achieving their health outcomes. This included promoting healthy eating, encouraging physical activity where appropriate, and ensuring people had access to relevant health information.

The provider routinely monitored people’s care and treatment to continuously improve it. However, we were not always assured people, and their relatives were fully involved.

Support plans were updated when people’s needs were changing. This included relevant risk assessments. However, more work was needed to ensure staff updated all relevant parts of the support plan. Whilst most of the locations had key workers, we found 1 location where this was not happening although people were still receiving regular meetings.

A relative told us they were no longer getting regular updates about their family members care and support. They said, “Since covid the meetings have stopped altogether. We asked for a care plan meeting and got told covid stopped them. We asked for them to start again and were told that the social worker’s not available.” Whereas another relative told us, “They do keep me informed of things.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, improvement was needed when completing capacity assessments.

While some Mental Capacity Act (MCA) assessments were time and decision-specific, in 1 location we found assessments included multiple decisions on a single form. This approach does not fully comply with MCA principles, which require assessments to be specific to each decision at the time it needs to be made. Most staff had a good understanding of consent and the importance of offering choice. However, some staff required further support to fully understand deprivation of liberty authorisations (DoLS) and their implications for people’s rights. The provider was aware of these areas for improvement and had begun taking steps to address them through additional training and review of documentation.