Lifeways Community Care (Taunton)

Lifeways Community Care (Taunton) is a supported living service providing personal care to people with learning disabilities and autistic people living in their own homes. People were supported over 13 different properties with some people living in self-contained flats and others living in single or shared accommodation. Not everyone who used the service received personal care.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were 34 people receiving personal care.

The service is also registered to provide domiciliary care services. At the time of the inspection the service was not providing domiciliary care services.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People were not always supported to have maximum choice and control of their lives; the policies and systems in the service to support this were not effective.

Where people lacked capacity to make decisions, the provider failed to follow the Mental Capacity Act (MCA) 2005 code of practice. Restrictions were placed on people without considering the principles of the MCA and there was not always clear evidence that the restrictions were in the person’s best interest. Not all options were considered when looking at the least restrictive option for people. Some practices restricted people's independence and choice, and breached their human rights.

People received their medicines from trained staff. However, improvements were needed to ensure guidance and administration records were accurate and up to date. Staff enabled people to access specialist health and social care support within the community.

The service completed assessments prior to people receiving a service, with care plans completed from the assessments. Care records viewed throughout the inspection were of mixed quality and were not always up to date.

Right Care:

People were not always protected from the risk of harm as staff did not always have all of the information needed to meet people's needs safely. Incidents were documented, however follow up processes and incident analysis needed improving to ensure people were given the appropriate support after an incident.

Recruitment processes were not always robust, and concerns were raised regarding staffing levels. Staffing levels were based on the needs of the people living at the supported living settings. The service was currently using agency staff to ensure safe staffing levels.

Staff received training in safeguarding vulnerable adults. Staff spoken with said they would be confident to report any concerns.

Right Culture:

There was lack of management oversight and reliable systems to inform the management of the quality of care people were receiving.

The culture within the service was not always positive. Staff did not always complete records about people in a dignified and respectful way, and improvements were needed to ensure people were involved in decisions about their care.

Staff did not always receive appropriate training and people were supported by staff who did not always understand best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have. This meant people did not always receive empowering care that was tailored to their needs.

Most relatives were positive about the service their loved ones received and felt involved. Where concerns were raised, these were discussed with the registered manager.

The registered manager was open and honest throughout the inspection, accepted the shortfalls found and immediately sought to rectify them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 4 July 2023, and this is the first inspection. Prior to the service becoming registered with us, the service was operating and being managed from another of the provider’s registered locations.

Why we inspected

The inspection was prompted in part due to concerns received about the culture of the service and how people who experienced emotional distress were supported by staff. A decision was made for us to inspect and examine those risks. Initially we completed a targeted inspection. Due to concerns identified during the targeted inspection, we changed our approach and completed a comprehensive inspection.

Enforcement

We have identified breaches in relation to governance, staffing, dignity and respect, consent, safeguarding, medicines, and risk management at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.