LIM Independent Living and Community Care Services Limited

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• 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

We assessed all of the quality statements within this key question. Our rating for this question has improved to Good. People were happy with the care and support they received from staff. People now received care and support that was tailored to them and their individual needs. The service was flexible and responsive to people’s needs, especially when these changed, and ensured continuity of care was maintained in line with people’s choices and preferences. People were now provided with information in a way they could understand and which met their individual communication needs. People were encouraged to speak up and raise concerns if they had these. Staff and the management team made sure people were listened to and involved when their concerns were dealt with. People using the service were treated equally and fairly and supported to access care and support that met their individual needs. The management team had improved their understanding of the challenges people might experience and used this to plan and deliver care and support, which met people’s needs in relation to their protected characteristics. Staff understood people’s equality and human rights and how these should be upheld and respected when providing them with care and support. Staff were supported by the management team to deliver care and support that did not discriminate against people. The service had arrangements in place to support people to plan for the future, including at the end of their life.

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.

People told us they were happy with the care and support provided. They received support from the same care workers and had got to know them well. They felt their preferences and lifestyle choices were respected and included in their care.

Staff provided care that was tailored to the person and their individual needs. They told us they asked people what they wanted and informed the management team, so that this detail could be included in people’s care plan. This ensured people received person-centred care that was in line with their wishes.

People were happy with the flexibility and continuity of care provided. This included when receiving support from a range of health and social care providers.

Staff told us where needed, they provided continuity of care. This included obtaining information from other healthcare professionals about people’s needs and following through on advice provided. For example, one person was receiving physiotherapy support and staff supported them to undertake their exercises daily.

Social care commissioners working with the service told us staff supported people to experience continuity of care which met their needs. They told us they had no concerns regarding the wellbeing of people who used the service.

Arrangements were in place to ensure care for people was joined up and promoted choice and continuity. One person had been supported to transition from having their care package funded by the local authority to paying for this privately. This had been their choice to do so. They had engaged a solicitor to support them to do this and act as their representative. The person and their solicitor worked with the service and the relevant healthcare professionals to ensure continuity of care was maintained as the necessary changes were made to their care and support package.

People were provided with information in a way they could understand and that met their communication needs. People told us staff adjusted how they spoke to them so they could understand. One person said, “If staff talk too quickly, I tell them and they slow down.” People also told us staff tailored their communication to ensure it was at times when they wanted to be spoken with or if they preferred staff to be quiet. One person told us, “If I am watching the Sunday Service they know to stay quiet.”

Staff were aware of people’s communication needs and provided information in a way they understood. One staff member told us, “We would use straightforward, plain language, actively listen, monitor non-verbal signs, and tailor our approach to each person's specific requirements and preferences.” Another staff member said, “You have to be close to [person using the service] to understand what she’s saying. But I visit her everyday so I know her.”

Systems were in place to ensure people received information in an accessible way that met their individual needs. This was assessed and recorded in their care plans and shared with staff to ensure these needs would be met. The service made information available to people in a format that met their individual needs. For example people who had difficulty with reading were supported to receive information in large print.

People and their relatives told us they felt comfortable speaking with their care workers and the management team. They felt able to raise any concerns and that these would be listened to and acted upon. None of the people we spoke with had any complaints about the service.

Staff told us they reassured people and listened if they had any concerns or wanted any changes to the way care and support was delivered. Care workers told us they would escalate any concerns to the management team so they could be acted upon.

Arrangements were in place to support people to raise concerns and complaints if they needed to. People were provided with information how to do this. The service had a complaints policy and procedure which set out how any complaints would be dealt with and what people could do if they remain dissatisfied with the service’s response. No formal complaints had been received by the service in the last 12 months.

People told us they were treated fairly and equally and staff supported them to access healthcare services when needed. People told us staff were accommodating and scheduled care calls at a time that was convenient to the person.

Staff told us they did not discriminate and people with a range of needs were welcomed and supported by the agency. They spoke with people to identify their needs and adjusted the service accordingly to ensure their needs and wishes were met.

Partner agencies felt there was equity in access to the service and the staff team worked with regard to the Equality Act 2010 and people’s protected characteristics.

Systems were in place to ensure people could access the care and support they needed in line with their preferences. The management team undertook, assessments, monitoring and reviews of people’s care needs and used information about people’s choices and preferences to plan care calls at the times people wanted. The service was flexible and accommodated changes to timings of care calls when people wanted this.

People’s individual needs were taken into account to ensure people received equity in experiences and outcomes. Staff spoke to people about things that were important to them, including reminiscing about places they grew up and respected people’s religion. A relative told us, “They chat to dad about Jamaica, his place of birth, tell him about the changes. They cook West Indian food, go above and beyond.” Another relative said, “If we are saying prayers, they remove their shoes inside the house.”

Staff ensured people experienced equity in outcomes. A staff member said, “I don’t impose my values on others, I respect everyone’s differences and treat them with dignity.” The management team made sure care and support was delivered in a way that removed barriers to people that might discriminate against them due to their protected characteristics. The registered manager told us, “We employ staff based on their abilities and don’t discriminate against people with protected characteristics. Staff have had training in diversity, equality, inclusion, and safeguarding.”

Systems were in place to obtain information about people’s individual needs and wishes in relation to their protected characteristics. The management team undertook assessments, monitoring and reviews of people’s needs to ensure this information was used to plan people’s care and support. Staff had access to this information through people’s care records. Staff received equality and diversity training as part of their role to help them make sure people were not subjected to discriminatory behaviours and practices.

People did not discuss their end of life planning with us.

Staff ensured the support they provided to people nearing the end of their life “protect[ed] the dignity and comfort of those making end-of-life decisions. We offer compassionate care, pain management, and emotional support.” Staff told us, “I’m not supporting people at the moment with end of life care, but I have done previously. We sit in with them and make sure they are not on their own.”

Systems were in place to obtain information about people’s individual needs and in particular their wishes for the support they wanted to receive at the end of their life. This helped to make sure staff would know what to do to make sure people’s wishes and choices were respected at the appropriate time.