Lifeways Community Care (Swindon)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

In this key question we looked at the 3 quality statements ‘Capable, compassionate and inclusive leaders’, ‘Governance, management and sustainability’, ‘Partnership and Communities’ and ‘Learning, improvement and innovation’. We found a breach of regulation in relation to the management of the services. Staff and relatives raised concerns about the lack of oversight by managers; many staff and relatives did not know who the manager was. The manager admitted that oversight was lacking in services. We found this had an impact on the care and support people received, for example in relation to ensuring safeguarding procedures were followed.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Multiple staff raised concerns with us about the management of the services and the communication from the management team. One staff told us: “the manager has never been to the service before… the manager doesn’t respond to emails or text messages”. Another staff told us: “I do not believe we have enough managers to go around, we hardly see a manager as they are always here, there and everywhere. I believe they are under just as much pressure as we are, but the higher management are not helping one bit. I don’t find you get much support from the managers due to this.”

We saw supervisions took place, but found leaders had raised concerns in supervisions which did not appear to be acted upon. We saw comments raised such as: ‘[Staff member] feels stressed, can’t enjoy the job at the moment due to the heavy workload.’ There was no evidence this had been addressed and we received similar feedback from staff during our assessment.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The manager told us they maintained oversight of services using online systems, which enabled the manager to monitor and audit services. However, the manager told us that management oversight is lacking due to staffing concerns. They told us: "I think at the moment where we have vacancies, [our main issue] is oversight. Being present in the service. We could definitely improve on that.”

Audits were not always in place or effective in managing risk. We saw some managers audits took place which did not identify the concerns found during this assessment. Audits did not always take place in a timely manner, for example we saw some audits were due in December 2023 but were not carried out until February 2024. Audits did not identify that incidents of unexplained bruising had not been reported as per the local authorities’ guidelines.

People told us they were able to access healthcare services such as the doctor surgery and the dentist when they wanted to.

The manager told us they worked well with healthcare professionals. The manager told us: “There is a [person] in one of the services who is declining in health, we went to the doctor surgery exploring possible [health condition], we have been working with the hospital, there has been a best interest decision to decide about [medical intervention]. Due to the possible diagnosis [of medical condition], we have done a referral for wheelchair services."

We requested feedback from healthcare professionals who work closely with the service but did not receive this. However, we received a recent quality report from the local authority which identified various actions which needed completing, such as care and support plans needing more information around people’s long term goals, support plans to be reflective of people’s needs, and some actions around safeguarding processes.

We saw referrals to external professionals were made where appropriate. For example, we saw that people had been referred to the speech and language therapy team where people were at risk of choking.

The manager explained their process for learning from incidents. They stated: At the end of each month I have the accident and incident forms, and compare the paper against [online system] and run a report, I will then feedback and filter it down the teams. We have a ‘lessons learned’ board in the office. I would like to introduce folders in the offices. This should be fed down in team meetings and supervisions.” However, we did not see any evidence that incidents had been consistently fed back to teams and discussed in team meetings.

We saw some evidence of staff being supported to share new ideas and innovation, such as continuing with the ‘star of the month’. However, there was no consistent process in place to allow for any learning from incidents and accidents. Therefore, similar themes occurred, such as unexplained bruising.