Lifeline Agency Limited

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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 a total of 6 quality statements from this key question. People and their relatives participated in their care plans and agreed the support they required. Staff worked well l with other health professionals to support people to maintain their health and notified managers of changes in people’s care that might require review of care arrangements. Some improvement was needed to people’s care and decision making records.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives, where appropriate, engaged in assessing, planning, and agreeing the care and support they received. One person told us, “We are involved with my care and my care plan, it all works well.” A relative said, “I am well involved with mum’s care plan. All runs perfectly well.”

Staff felt supported by information in people’s care plans accessed by an application on their phone. One staff member told us, “When you open the care application if there is something new it will show that there is an alert so will know to go straight to the alert to find out what has changed.” The registered manager or senior staff completed an assessment of each person’s needs prior to care starting.

Assessments were developed into holistic care plans which covered a range of areas. These identified key areas of needs, such as, personal care, daily living activities, meal preparation and health issues. However, some of these needed to be more comprehensive. For example, nutrition care plans did not contain people’s likes and dislikes and how they liked their food to be presented.

People were not able to give us any detailed feedback about how the service delivered evidence-based care and treatment.

The registered manager told us how the service provided care that was based on current good practice and met the needs of the person. Senior staff conducted competency assessments to ensure staff were following best practice and the advice provided by relevant health professionals. They also kept updated by newsletters from CQC and was signed up to websites providing latest updates on best practice.

The provider worked closely with health professionals to ensure the care and support they provided were based on evidence and best practice guidelines. Records showed staff were following guidance in relation to specific health concerns with information shared by health professionals. For example if someone were assisted to receive nutrition via a percutaneous endoscopic gastrostomy (PEG). A PEG is a feeding tube used to provide nutrition to people who cannot obtain nutrition by mouth or are unable to swallow safely.

People and relatives told us staff worked well with other teams and services. One person told us, “The doctor also is doing home visits everyone is working together.” A relative told us, “They all have the skill to provide the right care.”

Staff felt they worked well together. One staff member told us, “They are a good team. Would look at their care plans before visiting if new and to see if any changes. It is a good continuity of care, and we provide continuous support to clients. Work with additional team members such as district nurses. We meet with these and discuss changes and advice. One client had pressure sore and nurse visited weekly to redress this.”

A professional told us, “The registered manager will always keep us updated with any changes and engages well with Hampshire County Council.”

Records showed the service worked closely with many health professionals, including social workers, care managers, occupational therapists, district nurses, doctors, nutritionists, and physiotherapists. We saw care plans provided by health professionals which staff were following.

People felt supported by staff. One person told us, “I have a district nurse come in weekly to check on me, also to give me a monthly injection. Everything is in hand.” A relative said, “They know what to do when they come. They are fully aware of her illnesses.”

Staff told us they worked well with health professionals to assist people to live healthier lives. One staff member told us, “They feel very skilled when they face any difficult situation and will escalate for example by contacting the district nurses and is able to contact them for advice and help.” The registered manager informed us, they worked with many health professionals and any concerns staff would report on the electronic system which would create an alert to senior staff to report to health professionals. For example, they told us they have systems in place to monitor people’s skin health and staff would need to record and update this on their application before leaving the person’s home. Field supervisors will complete a weekly round to ensure this is being completed.

People were supported to access healthcare services when needed. Records showed one person was not always eating an appropriate diet for their diabetes. The registered manager said they could make their own decisions and were ensuring health professionals were aware as part of their review.

People felt staff were good at monitoring their care. One relative told us, “They are good at spotting redness on her skin and touch wood, no pressure sores.” Another relative said, “They record everything on their phone after each visit.”

Staff told us how they monitored people’s care. This was usually monitoring if people ate and drank enough when required. One staff member told us they were working with a person who had a stroke. They were following daily routines provided by the physiotherapists and the person appeared to be improving. The registered manager told us, how they reviewed people’s care needs to see if any changes to their care were needed. They worked with health professionals to agree people’s needs and care. For example, if they felt a person required more care they requested an increase of care. There was constant communication to support people. They told us of an example where one person was not eating while they were in hospital, but with staff support they started to enjoy their food again.

Staff recorded people’s completed care tasks on an electronic device on their mobile phones. This was monitored by senior staff to ensure people receive the care they needed when they needed it. Any concerns shared with health professionals or the local authority to improve outcomes.

People told us staff always gained consent before providing care. One person told us, “They shout hello, always ask how you are today.” Another person said, “Very respectful, always ask and say what they are doing.”

Staff told us they had received training in the Mental Capacity Act (MCA) and they always asked for consent before providing care. Some staff understood the MCA when we spoke to them however, other staff had limited understanding of how the MCA applied to their role. The registered manager told us that they did not do MCA assessments that this was up to health professionals. However, it is for the provider of care to ensure that they act in accordance with the law. Records showed these were in place for some people in parts.

Daily notes showed that consent was gained before providing care to people. Records showed capacity had been considered and relatives had been involved in supporting decision making where people might find it difficult to make decisions independently. However, records regarding best interest decision making and mental capacity assessment were not always comprehensive.