We carried out a review of the data available to us about Lifeways Community Care (South Shields) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lifeways Community Care (South Shields), you can give feedback on this service.
People's experience of using this service and what we found
People received safe care and were protected from abuse. Staff had received training in safeguarding and were confident to identify various types of abuse. Staff knew who to contact to raise any safeguarding concerns they may have. Risk assessments were in place which supported staff to care for people safely. Staff recruitment was safe and staffing levels were appropriate to meet the needs of people. When things went wrong, lessons were learnt from these and were shared with staff to prevent reoccurrence. Infection control procedures were in place and staff were seen to be wearing appropriate PPE. Staff told us they had received up-to-date training regarding infection control.
People received kind and compassionate care from staff. Relatives and professionals we spoke with were very complimentary regarding the level of support people received. Staff supported people to live with as much dignity as possible and staff were mindful to ensure people were supported to be as independent as they could be.
People received person-centred care and staff were very positive about the care people now received. People were involved in the daily planning of their lives which included what activities they wanted to do, what they wanted to eat, and what time they got up and went to bed. Complaints were investigated and actioned in line with the provider’s complaints policy. People were supported to maintain contact with their relatives. Staff knew how to communicate with each person and people had access to a range of ‘tools’ to support people with their communication.
The registered manager and all members of staff had worked very hard to change the previous culture and practice within the service. Staff told us they loved coming to work now as the changes and the improvements made the service so much better for the people living there. The registered manager completed various audits to monitor the quality of the service and care provided. Staff told us they felt valued and listened to. Staff now felt the service was back to where it belonged, and that was for the ‘lads’ living there as it was their home.
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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.The model of care and support provided to people living at the service maximised their choice, control and independence. People were involved in all aspects of their care and future planning. Care provided at the service was centred around the person and promoted people’s dignity, privacy and human rights.The ethos, values, attitudes and behaviours of the management team and staff ensured people lead confident, inclusive and empowered lives.
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 16 December 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced focused inspection of this service on 28 August 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the breaches of regulation found in person-centred care; dignity and respect; safe care and treatment; safeguarding service users from abuse and improper treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Caring, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lifeways Community Care (South Shields) on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People's experience of using this service and what we found
People had not always received person-centred care or received the emotional support as outlined in their care plans. Staff told us the service was very regimented and at times institutional. People had not always been allowed to choose their own range of activities.
Systems in place had not been effective in protecting people from abuse. Staff told us they were aware of the whistleblowing policy and had identified and raised concerns with both the registered manager and the senior service manager. These concerns were regarding poor practice and management culture within the service, but nothing ever changed.
Management of the service had not successfully identified the issues we found during the inspection. This included inappropriate actions which had been recorded in one person’s care plans not being fully investigated. Outstanding actions in relation to premises safety checks had not been followed up or completed. People’s hospital passports did not always contain up-to-date information to allow people to receive safe and consistent care if they were admitted to hospital.
The majority of staff told us they did not feel supported, listened to, or valued by their registered manager and senior service manager, and they often felt stressed and demotivated. Staff had attended regular team meetings and supervision sessions with the registered manager/team leader. However, the majority of staff told us they had not found these meetings to be of any benefit.
Management had failed to follow the provider’s own organisational process, regarding the investigation of internal concerns and one external investigation.
Staff had received training to support them in their role. Staff, relatives and a visiting professional told us people received safe care.
Robust infection control procedures were in place for people, staff and visiting professionals to the service.
People’s communication needs were assessed and recorded in their care plan. During the inspection staff were seen to engage with each person in their unique way and people responded very well.
The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, lack of choice and control, limited inclusion e.g. people did not have choice in their range of activities.
The senior service manager present during inspection, was very open and honest with the inspector during and after the inspection process. They listened to all feedback provided, and they and the provider, took immediate action to address the concerns which had been raised.
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 June 2018).
Why we inspected
We received concerns in relation to the management of the service and a potential closed culture environment. As a result, we undertook a focused inspection to review the key questions of safe, caring, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key question. We therefore did not inspect this. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection. Please see the safe, caring, responsive and well-led sections of this full report.
Enforcement
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.
We have identified breaches in regulations 9, 10, 12, 13 and 17 at this inspection.
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 six 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.
At the last comprehensive inspection we rated the service Good. At this inspection we found the service remained Good. We found no breaches of regulations and the service was meeting the legal requirements.
The premises were safe. Regular checks of the premises, equipment and utilities were carried out and documented. People’s care plans reflected their individual needs and risks were assessed. We found there were policies and procedures in place to help keep people safe. Staff were safely recruited and they were provided with all the necessary training required for their role.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
There was a complaints procedure in place at the service. Any complaints received were logged electronically on the provider’s system, action plans were created and lesson learned documented. We saw records of activities undertaken by the residents and relatives told us that people were supported to carry out their own choices for activities. There was training provided for staff in delivering end of life care and we saw evidence of this reflected in people’s care plans.
Staff treated people with dignity and respect. We saw kind and caring attitudes and relatives told us that the staff were very supportive. We observed people enjoyed positive relationships with staff and it was apparent they knew each other well. People and their relatives told us that staff knew what they liked and disliked.
There was a robust governance framework in place to continually monitor and improve the service. We saw evidence of involvement from the provider’s senior management team and documented audits carried out during their visits to the service. The manager was aware of their responsibilities and had a clear vision for the service in partnership with the provider’s organisational vision. The current manager was undergoing their registration with the Commission to become the registered manager, as the previous manager had left the service.
'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.'
Further information is in the detailed findings below.
The inspection took place on 22 and 27 October 2015 and was announced, which meant the provider knew we were coming. The provider was given 48 hours’ notice because the location was a small care home for adults who are often out during the day, so we needed to be sure someone would be in.
The last inspection of this home was carried out on 24 September 2013. The service met the regulations we inspected against at that time.
Lifeways Community Care (South Shields) provides care and support for up to four adults with learning and physical disabilities and associated complex health needs. At the time of this visit four people were using the service.
The home is a large four bedroom house in a residential area. People’s rooms were on the ground floor with one bathroom shared between two people. People had access to a communal lounge, kitchen and dining room. The first floor housed the registered manager’s office and a staff sleep-in room.
The registered manager has been in post since 2010. 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.
The people who lived at the home had complex needs that limited their communication. Relatives made positive comments about the service. They described the service as safe. Relatives felt involved in decisions about their family members’ care.
Staff knew how to recognise and report abuse. The provider made sure only suitable staff were employed. Medicines were managed in a safe way, and records were up to date with no gaps or inaccuracies.
Staff were familiar with people’s individual needs and received relevant training to support each person in the right way. Staff received regular supervisions and appraisals.
People were supported to enjoy a healthy diet which met their individual dietary needs. Staff were knowledgeable about people’s likes and dislikes in relation to food, as well as activities and what clothes people liked to wear. People were encouraged and supported to make their own decisions where possible.
Care records were up to date and reviewed regularly. Each care plan was person centred and specific to the person’s needs as an individual. Staff were caring and supportive when talking with people. There were good relationships and communication between people, relatives and staff.
People had a range of activities they could take part in which were discussed with them weekly. People and their relatives had information about how to make a complaint, although none had been made recently.
Relatives and staff felt the home was well managed. There was a positive and open culture at the home.
Systems were in place to record and monitor accidents, incidents, complaints and safeguarding concerns which helped the provider monitor the quality of the service.
One person we spoke with said he was happy living at the home and liked the staff. He told us that he helped out in the home by washing dishes and answering the door. Relatives we spoke to told us they were happy with the care provided at Lifeways. One relative told us 'The staff have been very good'.
The service planned and delivered care and support so that people's needs were met. Staff supported people in an engaging way and regular activities were arranged. A relative told us 'If I didn't think it was the place for him, I would move him'.
The service had an effective recruitment and selection procedure in place and carried out relevant checks when recruiting staff. The service also had an effective system in place to deal with comments and complaints.
The manager had systems in place to regularly check the quality of the care and people were consulted about the care they received.
Each person had their own bedroom with an en suite. The people within the service were able to choose the decorations for their bedrooms.
We observed care staff talking to people appropriately and providing appropriate levels of encouragement to ensure they maintain their independence. During our inspection each person within the service went out with care staff for an activity within the community.