Archived: Lifeways Community Care (Warwickshire & Coventry)

About the service

Lifeways Community Care (Warwickshire & Coventry) is a supported living service providing personal care to people with learning disabilities and autistic people living in their own homes. 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 19 people receiving personal care.

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

Right Support:

Most people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests, the policies and systems in the service supported this practice. For one person further review was required to ensure they were being supported to maximise their capacity and choices.

Some people’s care plans did not contain key information on how to support them, but staff knew people well. Staff received training and had competency assessments to ensure they had the skills to work with people.

Right Care:

The quality of person-centred care people received across the different supported living settings was not consistent. In one setting improvements were required to ensure people received care that supported their needs and aspirations, whilst in other settings this was in place for people.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People told us they received care from staff who were kind. We found however, that some language used in care plans needed improvements to ensure people were treated with dignity and respect.

Right Culture:

The management team were making changes to promote a positive culture and people and staff told us they had seen improvements. These improvements required further embedding and to be applied consistently to ensure people’s wishes, needs and rights were at the heart of everything they did. The registered manager was quick to respond to the concerns we identified on inspection, however systems needed improving to ensure concerns were identified to ensure a culture of continuous improvement.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 24 January 2023) and there were breaches of regulation. At this inspection we found improvements had been made however, there were ongoing breaches of regulation 9, person-centred care and regulation 17 good governance.

This service has been in Special Measures since 27 September 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 25 July 2022. Breaches of legal requirements were found. We undertook this inspection to check if they now met legal requirements.

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

Enforcement and Recommendations

We have identified continued breaches in relation to person-centred care and governance. We have imposed conditions on the provider's registration and asked them to send a monthly report that shows what action they are taking.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Lifeways Community Care (Warwickshire & Coventry) provides personal care to people in their own homes within supported living and domiciliary care settings. 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, some of whom may have a learning disability, autism, mental health needs or physical disability.

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

The service was not always able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support:

The provider had not fully protected people from the risk of abuse and improper treatment. Individual risks were not always assessed and managed to keep people safe. Risk assessments were inconsistent and did not always detail the relevant information staff would need to meet people's assessed care and health needs. Incidents and accidents involving people were not consistently reported, recorded and investigated.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right Care: The provider did not protect people from poor care and abuse. The provider failed to ensure service users were always treated with respect and dignity whilst receiving care and treatment. There were not always enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture: The provider did not always place people’s wishes, needs and rights at the heart of everything they did. The provider had failed to implement effective systems to assess, monitor and improve the service. We found the language used in some people’s care plans to be disrespectful and undignified.

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

Rating at last inspection

The last rating for this service was good (published 29 April 2019).

Why we inspected

The inspection was prompted in part due to concerns received about a closed culture, allegations of abuse and neglect and poor managerial oversight. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report.

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

The provider has taken some steps to mitigate the risk since our inspection. This includes liaison with relevant partner services to keep people safe and developing a service improvement plan.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care, dignity and respect, need for consent, safe care, safeguarding, meeting people’s nutritional and hydration needs, governance and staffing at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

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. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

Improvements had been made following our previous inspection to address the areas we identified as requiring improvement.

People felt safe and were supported by staff who understood how to report concerns and manage risks to keep people safe. The registered manager acted and reported safeguarding concerns when these were identified. Staff were recruited safely and people were supported by a regular team of staff. Medicines were given in a safe way and lessons were learnt when things went wrong.

Staff received training that was appropriate to them in their role and supported them in providing care in the way people wanted. Staff spoke positively about the support they received. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people.

People told us staff were kind and caring and treated them with dignity and respect. People had regular care staff who knew how they liked to be supported.

The provider had a system in place for responding to complaints. People knew who to contact if they had any concerns.

The provider had quality assurance systems in place, however they were not fully effective as they had failed to identify other areas requiring improvements.

Rating at last inspection: Requires Improvement (report published December 2017).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

Enforcement:

No enforcement action was required.

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

Lifeways Community Care Limited (Dudley) is registered to provide personal care services to people in their own homes or supported living. People the service supports have a range of needs including physical disability and learning disability. On the day of the inspection, 35 people were receiving support.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

People felt safe and care staff knew how to keep them safe having had safeguarding training. There was, however, not always enough care staff for the supported living service in which the provider had recently started to provide care. People were able to get the support they needed with their medicines.

While the provider adhered to the requirements of the Mental Capacity Act (2005) to ensure people’s human rights were not unlawfully restricted, care staff were not always aware of the best interest decision. Care staff did not always have the skills and knowledge required to support people as they needed. People were able to access health care when needed.

People were able to access an advocate when needed. People were supported in a kind and compassionate manner. People’s privacy dignity and independence was respected and people were able to make decisions as to how they were supported.

Whilst the provider ensured people were able to share their views as part of an assessment and care planning process, people’s equality and diversity was not considered as part of the process. The provider’s complaints process enabled people to raise concerns they had.

We found whilst ‘spot checks’ and audits were taking place, they were not sufficiently effective in identifying areas of concerns within the service that needed to be improved. Comprehensive and accurate care records were not consistently available in the provider’s office to illustrate how people were being supported, how risks were being managed and the content of care reviews. People’s views were gathered to evaluate the quality of the service they received.