Living Ambitions Limited - Essex

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 64 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The provider ensured overall care was responsive and tailored to each person’s individual needs, preferences, and circumstances. Staff knew people well and responded promptly to changes in need, acting to minimise discomfort, concern, or distress.

Whilst support plans reflected what mattered most to people, as stated in other sections of this report additional work was needed to ensure electronic support plans contained up to date and accurate information throughout. We also made the registered manager aware some relatives were not feeling fully involved in the support planning and review processes.

Staff work collaboratively with external professionals to ensure timely access to appropriate support. People are supported to make choices about activities, community involvement, and daily living, with co-production used to plan meaningful opportunities.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People and relatives told us they or their family member received support from medical and other professionals when required. One relative said: “When [person] was ill and it was an emergency; staff went to hospital with them. The service told me straight away that [person] had gone in. The staff stayed with [person] a suitable amount of time.”

Staff we spoke with demonstrated a good understanding of working collaboratively with others to support people in meeting their outcomes. A staff member told us: “SALT comes in to see two people. We take people to physios and occupational therapists.” This approach ensured people had timely access to healthcare and specialist input, promoting continuity of care and positive health outcomes.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

In one location, while various communication formats were listed in people’s support plans, staff were unaware if these were available. For example, one health action plan stated the person would require pictorial guides or videos to understand procedures or treatments. However, we found no evidence these were being used, and staff told us the person would not use these. This meant we were not assured support plans were accurate or staff were aware of this information.

In contrast, other locations we visited had a range of accessible information available to people in different formats, supporting choice and understanding. Overall, improvements were needed to ensure communication needs recorded in support plans were accurate and consistently implemented in practice across all locations.

The provider told us in their provider information return they used the easy read guide, which where appropriate was downloaded or support provided to enable people to download this themselves from the website to help share their communication needs. People’s communication needs were recorded in their support plans and communication passports.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Living Together meetings were held at various locations to obtain feedback and gather ideas. A staff member told us a representative from the landlord had started attending these meetings to listen to feedback about the environment. They added: “We have also started diaries with people they can fill out.” Another staff member said: “People we support attend the meetings; they come together and talk to the staff about what they need and want. It enabled us to get a new bed for a [person] and a nice birthday party/cake for another.” A person told us: “We have meetings which are good, and I can speak up.”

Surveys for family members were in place; however, the information we received was unclear about what action the registered manager took when comments were less favourable. We also received mixed views from relatives about their involvement and communication, as noted in other parts of this report. Overall, while systems were in place to gather feedback and involve people in decisions, improvements were needed to ensure relatives’ feedback was acted upon and communication was consistent across locations.

The provider made sure people could access the care, support and treatment they needed when they needed it.

We saw evidence people were receiving support from relevant professionals to meet their needs such as the GP, district nurses or occupational therapist and learning disability teams. Staff had good understanding of when and how seek support for the people they supported.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff had a good understanding of the people who use their service that are most likely to experience inequality in experience or outcomes and take steps to minimise barriers to inclusion and positive experiences. The registered manager was aware of 1 location where improvements were needed and was actively addressing this.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

While we saw evidence of staff working with relevant agencies when there was a deterioration in a person’s health, support plans did not consistently record conversations about people’s needs, wishes, and preferences for end-of-life care. This meant there was a risk people’s choices may not be fully understood or respected should their health needs change suddenly. More work was needed to ensure discussions about people’s future care, including end-of-life preferences, were held and clearly recorded in support plans.