Luv To Care Home Care Ltd

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• 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

We assessed 3 quality statements in the effective key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was requires improvement. Based on the outcome of this assessment the combined scoring for this key question has improved and the effective key question has been rated good overall. The provider had processes in place to ensure people's needs were assessed before they received care. Assessments included information for staff on people's individual diagnosis, health needs and how they would like their needs to be met. The provider used some nationally recognised practice tools to support them to identify and monitor risks to people such as the risk of malnutrition and tissue viability. Staff sought consent from people before assisting tasks, and the provider operated effective systems to act in people's best interest where they were assessed to lack capacity.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people told us they and/or their loved ones were involved in discussions about what their care needs were before a service was provided. Comments included, “Yes I was involved initially and have a copy of my care plan in my possession.”, “Yes, we communicated what we needed. One of the managers came and visited and brought everything with her so we could sign it.” and, “Yes, I was involved and yes I have read and consented to [my care plan].” However, people were not always clear if they had received a review of their care after the initial set up.

Staff we spoke with had a good understanding of what people’s needs were and how to meet them. Leaders responsible for assessing people's needs had a good understanding of the information they needed during the assessments and how this was communicated with staff. Assessments also included information for staff to be aware of for any possible hazards within a person’s household. Where people required updates to their needs assessment this was managed by the office staff.

Care records for people were detailed and covered people’s individual diagnosis and information for staff on how to meet peoples needs and preferences. The provider sought relevant information to make informed assessments of peoples care which included their past history and known risks such as whether the person had a history of falls. Where people benefited from support from other services such as the district nursing team, the provider had processes in place to escalate concern and share relevant information to ensure people had access to appropriate care and support.

Not all people we spoke with required support with their eating and drinking. However, where they did we received mixed feedback. Most people were happy with the support provided and told us staff supported them to purchase, cook and make meal choices. However, some people felt staff did not always support them fully. For example, a person said “I am supposed to have staff stay with me when I eat but most carers give me my meals and beaker of drink and then leave. They should be with me for 45 minutes but mostly leave after 20 minutes.” People we spoke with were able to access or were provided with snacks and drinks outside of their care call visits. This was either by staff leaving out items or informal support from relatives and loved ones.

Staff we spoke with were aware of people’s medical conditions and what signs and symptoms they may need to be aware of to support them. Staff told us they had access to training to support their understanding. Some staff told us they would like additional training in areas such as diabetes management which we shared with the provider to action. We spoke with staff about people's individual prescribed diets, such as people who required modified diets and thickened fluids. Staff demonstrated they had a good understanding of people's individual needs, however they were not familiar with standardised terminology such as the international dysphagia diet standardisation initiative (IDDSI).

The provider used a range of best practice tools to support them to identify and monitor risks to people. For example, they used nationally recognised tools to screen and manage risks to peoples skin integrity and risk of malnutrition. Where people were assessed as requiring a modified diet, care records were clear and detailed for staff to follow. Staff we spoke with were confident in meeting people's individual dietary needs. However, we have recommended the provider reviews best practice guidance to ensure common terminology and consistency of textured food is embedded, such as the nationally recognised IDDSI framework.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us that most staff sought consent before providing care and support. Overall people gave positive feedback that they felt able to make choices. Comments included, “I do, yes make all my own choices how I live my life.”, “I do what I want to do every day and I am not restricted in any way.”, “I am not restricted in any way and the carers are very pro-choice.”, and, “I make my own choices daily and can cancel my carers anytime if I want to.”

Staff understood the importance of obtaining people's consent before assisting with care and support tasks. Staff told us how they supported people to make decisions about there care to enable people to maintain their independence. Staff told us they encouraged people to make day to day choices such as selecting clothes and meals. Staff were clear where they could find important information about people's wishes such as advanced decisions and how to share this with relevant professionals in the event of an emergency.

People’s care plans and care notes clearly captured how staff should promote choice and where consent was needed. Where required, we found appropriate documents were in place evidencing where people had provided consent to their care. Where people were assessed as lacking capacity to make specific decisions about their care, the provider had processes in place to ensure they considered the legal framework and consulted with relevant people and professionals when acting in the persons best interest. Where people had elected relatives or loved ones to make decisions on their behalf, this was clearly recorded and the provider ensured relevant checks were completed to confirm who had this authority.