Livi UK

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

We found that the service was providing effective services because: • The provider assessed patient needs in line with best practice guidance, and ensured all staff were aware of the service’s protocols and procedures. • The service had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided. • Staff worked together, and worked well with other organisations to deliver effective care and treatment. • The service obtained consent to care and treatment in line with legislation and guidance. However, the service did not always inform patients’ own GPs of prescribing of which they would need to be aware.

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.

Service users providing feedback did not comment on the the assessment of their needs.

The service utilised local and national guidance to determine how patient needs should be addressed. We undertook a review of patient records at the service, and found that these guidelines were being followed in the large majority of cases. Patients’ immediate and ongoing needs were fully assessed. Where appropriate this included their clinical needs and their mental and physical wellbeing.

The service had policies and protocols in place to ensure that patient needs were assessed, and followed national and local guidelines where required. As part of the assessment a number of clinical records were reviewed by a CQC GP specialist advisor, and we found that in the majority of cases, patient needs were assessed.

Service users who gave feedback did not comment on how staff and teams worked in line with best practice.

Staff told us they received regular updates from leaders at the service. Where there were updates to ways of working, training and monitoring was delivered to ensure that it was properly integrated.

Clinical staff had access to guidelines from the National Institute for Health and Care Excellence (NICE) and local guidelines relating to service management and used this information to help ensure that people's needs were met. The provider monitored that these guidelines were followed. Patients’ needs were assessed. This included their clinical needs and their mental and physical wellbeing. Where patients’ needs could not be met by the service, staff redirected them to the appropriate service for their needs. Care and treatment was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

Service users who gave feedback did not comment on how staff and teams worked together to deliver care.

Staff were aware of the need to complete accurate and full records, such that information did not need to be repeated by patients. Patients received coordinated and person-centred care. This included when they moved between services. Care and treatment for patients in vulnerable circumstances was coordinated with other services. Staff communicated promptly with patient's registered GPs where relevant and where consented, so that the GP was aware of the need for further action. However, we noted that there were occasions where prescriptions were provided, which the patient’s own GP would need to be aware, such as additional medicines to control long term conditions. This had not been provided, because the patient had not consented for this information to be shared. The provider reported that they would review this in future.

The service’s partner organisations reported that they were satisfied with the way in which the service shared care and engaged with other healthcare providers.

The service ensured that care was delivered in a coordinated way and took into account the needs of different patients, including those who may be vulnerable because of their circumstances. There were clear and effective arrangements for booking appointments, and transfers to other services.

Service users giving feedback mentioned the convenience of online appointments but did not specifically comment on how the service supported them to live independent lives.

The service is a digital service, so does not see patients directly face-to-face. The service advised patients on self-care as required.

There were no concerns in relation to how the service supported patients to live healthier lives.

Service users giving feedback did not comment on the monitoring and improvement in their healthcare.

Leaders and staff at the service told us that there were two primary methods of quality review; there were medicines and treatment audits, plus an audit of selection of individual clinicians’ patient consultations. Staff and leaders provided details of an extensive audit programme.

Individual clinical staff at the service were subject to regular audits of a percentage of their consultations. Where staff had not met the minimum standards required by these audits, there were escalation measures in place in line with the organisation’s own policies. The provider also provided an audit schedule and numerous completed audits that had been through more than one cycle. Audits had learning points that were fed back to staff.

Service users who expressed an opinion did not mention any issues concerning consent to care.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making.

Relevant staff had been provided with training in the Mental Capacity Act. The provider monitored the process for seeking consent appropriately.