Archived: Lifeways Community Care (Plymouth)

Updated 13 March 2015

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.

The inspection took place on 13 and 14 January 2015 and was announced because the location provides a domiciliary care service. Also the registered manager had responsibility for two office sites and we wanted to make sure they could be available for the inspection visit. The inspection was carried out by two inspectors.

We reviewed previous inspection reports before the inspection. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send to us by law.

We visited by agreement, three houses in Plymouth and Cornwall into which the service delivered supported living support to people. During these visits we met with five people. We spoke with eight members of staff and the registered manger. We also contacted three relatives by telephone and spoke with an external healthcare professional.

We looked at six people’s care records, three staff records and a variety of documents associated with the management of the service including quality audits.

Updated 13 March 2015

We inspected Lifeways Community Care (Plymouth) on the 13 and 14 January 2015. The inspection was brought forward in response to concerns raised about the supported living service provided into one house. We last inspected Lifeways Community Care (Plymouth) in April 2013, there were no concerns identified at that time.

There was a registered manager in post who had responsibility for Lifeways Exeter office as well as Plymouth. 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.

Lifeways Community Care (Plymouth) is a domiciliary care agency, run by the provider Lifeways Community Care Limited. It provides personal care and support for people with learning disabilities and people with significant physical and mental health needs in their own homes. The care ranges from a few hours of support a week up to 24 hour care for people in supported living. A supported living service is one where people live in their own home and receive care and support in order to promote their independence. People have tenancy agreements with a landlord and receive their care and support from the domiciliary care agency. As the housing and care arrangements are separate, people can choose to change their care provider without losing their home. We visited by agreement, people living in three houses where supported living support was being provided by this service, two in Plymouth and one in Cornwall. One was a shared house where people had their own bedrooms and shared the other parts of the house with staff supporting them throughout the 24 hour period.

Relatives told us they had little contact with the main office and two did not know where it was or the name of the registered manager. They were not sure how to make a complaint or who to, other than the staff they knew at the service.

Audits had identified problems with the service delivered into one house. However this had not been acted on in a timely manner and people were not therefore protected from risk. Following the Lifeways audit the local authority had also carried out checks on the service and identified similar issues. These included out of date and inaccurate care plans and lack of staff support.

Relatives told us they believed their family members were well supported by Lifeways care staff and that they were safe. The people we visited were relaxed with their carers’ and interactions were friendly and respectful. Staff were following the principles of the Mental Capacity Act 2005. They knew how to make sure people, who did not have the mental capacity to make decisions for themselves, had their legal rights protected. We found one person was deprived of their liberty by the service in order to keep them safe, without appropriate legal authorisation. We have made a recommendation about staff training in relation to the Mental Capacity Act (2005)

Staff had a positive approach to the management of risk. They told us they tried to balance keeping people safe and minimising risk with allowing people to maintain their independence and try new activities if they wanted.

Recent organisational changes at Lifeways Community Care Limited had resulted in some dissatisfaction amongst staff and there had been a number of resignations over the previous year leading to a shortage of staff. There was an ongoing recruitment campaign taking place and the registered manager told us they believed they would soon be fully staffed. We looked at the rotas for two of the teams that provided services into two houses we visited and found that staffing was appropriate. Senior staff with responsibility for individual services told us they always managed to deliver the staff required although they sometimes needed to use agency staff. However they said they were always able to deliver staff who were familiar with the people they were supporting.

Staff were knowledgeable about the people they supported and were able to describe how best to support them in detail. They spoke about people fondly and respectfully demonstrating a positive approach to helping people maintain independence and achieve goals.

Lifeways provided staff with training relevant to the needs of people they were supporting. Formal supervision was irregular but staff told us they felt well supported. The team supporting one house had not had a team leader in post until very recently. Staff had felt isolated but reported that things had now improved. Team leaders were acknowledged as being “pivotal” members of staff. However they had limited protected administration hours and this meant they sometimes found it difficult to complete all their duties which included supervisions. We have made a recommendation about the management and recording of staff development.

Lifeways had a well-defined management structure. The registered manager oversaw ‘service managers’ (team managers) who had responsibility for a number of support teams. Each support team had a team leader who supervised the staff. This meant there were clear lines of accountability and responsibility in place.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.