Lifeways Community Care (Cheshire)

Updated 18 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 September and was announced.

The registered provider was given 48 hours’ notice prior to inspection visit. Notice is provided because the location provides a supported living service and we needed to be sure that staff would be available to support us on the day.

The inspection team consisted of one adult social care inspector and an ‘expert by experience’ who supported with phone calls to relatives. An ‘expert by experience’ is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit we reviewed the information which was held on Lifeways Community Care (Cheshire). This included notifications we had received from the registered provider such as incidents which had occurred in relation to the people who were receiving support. A notification is information about important events which the service is required to send to us by law.

A Provider Information Return (PIR) was received prior to the inspection. This is the form that asks the registered provider to give some key information in relation to the service, what the service does well and what improvements need to be made. We also contacted commissioners and the local authority prior to the inspection. We used all of this information to formulate a ‘planning tool’ which helped us identify key areas we needed to focus on during the inspection.

During the inspection we spoke with the registered manager, three service managers, one member of staff and four relatives over the phone.

We also spent time reviewing specific records and documents, including five care records of people who were receiving support, five staff personnel files, staff training records, medication administration records and audits, complaints, accidents and incidents and other records relating to the management of the service.

Updated 18 October 2018

This inspection took place on 12 September was announced.

This was the first inspection of this service since the registered provider had registered with the Care Quality Commission (CQC) in April 2017.

Lifeways Community Care (Cheshire) is a ‘supported living service’ that provides care and support to people living in multiple 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. Lifeways Community Care (Cheshire) provides a service to younger and older adults who are living with complex support needs. These values include choice, promotion of independence and inclusion. At the time of the inspection the registered provider was providing support to 16 people.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Individual care plans and risk assessments were checked during the inspection. We found that records were well maintained, regularly reviewed and contained the most relevant and up to date information. Risks were clearly identified and measures were put in place to mitigate risk and keep people safe.

Medication management systems were safely managed. People were administered their medication by staff who had received the necessary medication training. Medication audits were effectively being carried out and staff were complying with medications administration policy.

The registered provider had an accident/incident reporting procedure in place and staff understood the importance of reporting any accidents and incidents that occurred. The registered manager ensured that a routine analysis of all accidents and incidents took place as a measure of identifying and managing risk.

People were protected from avoidable harm and risk of abuse. Staff were familiar with the area of safeguarding and whistleblowing procedures and explained who they would report their concerns to. Staff had also completed the necessary safeguarding training.

The area of ‘recruitment’ was safely and effectively managed. This meant that all staff who worked for the registered provider had suitable references and disclosure and barring system checks (DBS) in place.

Health and safety procedures were in place. There was an up to date health and safety policy and staff appreciated the importance of complying with health and safety procedures.

The service was operating in accordance with the principles of the Mental Capacity Act, 2005 (MCA) and consent was sought in line with people’s best interests. Staff received training in relation to the mental capacity and were familiar with the underlying principles.

Staff expressed that they were fully supported in their roles. Staff received the necessary training they required to provide people with the support they needed. Staff also received regular supervisions and annual appraisals.

The day to day support needs of people who were receiving support was well managed. Appropriate referrals to external healthcare professionals were taking place and the relevant guidance and advice which was provided by professionals was followed accordingly.

People’s nutrition and hydration support needs were assessed from the outset. The registered manager ensured that any risk surrounding nutrition and hydration was effectively managed. The appropriate risk management plans reflected the level of care and support that was needed in this area of care.

People received a good level of dignified and respectful care. Staff were familiar with the care needs of the people they supported and explained the importance of respecting people’s individual needs, wishes and preferences.

Confidential information was safely stored at the registered address. Personal and sensitive information was protected in line with General Data Protection Regulations (GDPR) and sensitive information was not unnecessarily shared with others.

People and relatives were provided with a ‘service user’ guide from the outset. This contained essential information in relation to the care and support people could expect to receive.

Care records we checked were tailored around the person and contained a variety of person-centred information. The information enabled staff members to develop a wealth of knowledge and understanding about the people they were supporting.

People were supported to actively engage and participate in hobbies they were interested in. Staff were familiar with people’s interests and supported them to access a variety of different activities on a weekly basis.

A complaints policy was in place. This was currently under review and ready to be circulated following the inspection process. The complaint policy we reviewed contained information in relation to the complaints process and how complaints would be responded to. Relatives confirmed they were familiar with the complaints process.

At the time of the inspection, nobody receiving support by Lifeways Community Care (Cheshire) were receiving ‘End of Life’ support. Staff could access ‘end of life’ training upon request but this was an area of training that was being explored further by the registered manager.

The registered provider had a number of different quality assurance systems in place. Such quality assurance systems included weekly and monthly audits, competency assessments, annual questionnaires and team meetings.

We reviewed the range of different policies and procedures the registered provider had in place. Policies we reviewed included safeguarding adults, whistleblowing, health and safety and medication administration policies.

Policies and procedures were available to all staff and staff were able to discuss specific procedures and processes with us during the inspection.

The registered manager was aware of their responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with the CQC’s statutory notification procedures.