Lifeways Community Care (South London)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There were systems in place that enabled the provider to learn from their mistakes when things had gone wrong. Staff were encouraged to raise concerns and share learning through regular supervision, team meetings and daily communication systems. Staff described feeling supported by the service and other senior managers to learn and develop. Managers and staff understood the importance of reporting safety concerns and promoted reflection and continuous improvement. Changes were made to the service when needed because of this learning. For example, adapting care plans, reviewing systems and providing additional staff training.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to them receiving a service. This information was used to develop person-centred care and risk management plans which were shared with staff to help them provide safe and appropriate care to people from the moment they start receiving a home care service. Staff worked with other health and social care professionals, the person and anyone important to them to enable smooth transitions between different care services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People expressed feeling safe with staff who regularly supported them. One person said, “I do feel safe living here in my own flat. I get on well with all the staff that support me at home.” A community-based care professional added, “My client is kept safe. If there was any safeguarding issue, I can confidently say the provider would approach this correctly.” Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A staff member told us, “I’ve had safeguarding training and I know I have to tell the service manager if abuse or neglect happens to anyone we support.”

Managers worked proactively with the relevant agencies when a concern was raised and took appropriate action to safeguard people from further risk. A service manager told us, “I know I must notify the local authority, CQC, the family and where necessary, the police without delay, if I suspect people we support have been abused or neglected in anyway.”

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a Deprivation of liberty Safeguard (DoLS) authorisation was applied for through the relevant local authority. The area manager told us they were aware of the recent Supreme Court judgement where the threshold for deprivation under the DoLS framework had changed.They told us they had updated their policy for assessing people who might have been deprived of their liberty in line with the new framework and they were working with the local authority on any new applications.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider involved people in managing risks and supported positive risk‑taking to promote independence and wellbeing. People’s care records contained sufficiently detailed information for staff to follow to ensure risks they might face were mitigated, so far as possible, so people remained safe when taking part in activities of daily life. Staff demonstrated a good understanding of people’s individual needs, communication styles and life histories, and used this knowledge to support people to understand and manage risks in meaningful and personalised ways.

People were educated about staying safe when they weren’t being supported by staff. Managers and staff worked with people to develop their understanding of risks in their own home and in the wider community. Staff described how they balanced risk with independence, enabling people to undertake positive risks for themselves whilst remaining safe.

Staff regularly reviewed risk assessments and risk management plans to make sure these were personalised, accurate and took account of people’s changing needs. For example, adjusting assessments and plans when people experienced deteriorating health.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider assessed risks in people’s living environments and put measures in place to reduce these and keep people safe. They made sure equipment, facilities and technology supported the delivery of safe care. People’s accommodation was kept free from unnecessary slip or trip hazards and obstacles which enabled people to move safely around their home.

Managers and staff routinely conducted in-person monitoring home visits to help them identify and mitigate any potential environmental health and safety risks. Issues identified through these checks were reported to the housing provider for action.

There was an up-to-date fire risk assessment for the accommodation where people lived and a personal emergency evacuation plan for each person. People knew what to do in the event of an emergency, including a fire.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider had undertaken assessments with people to identify their specific care and support needs. Information from these assessments was used to develop individualised plans for people receiving a home care service. Staff shifts were planned to reflect the needs of people, they provided a home care service to, including additional support for community-based social activities and health care appointments. One person told us, “There is always staff about to help me whenever I need them.” The service did not use any agency staff and continued to experience low rates of staff turnover. This was confirmed by the service manager who told us, “The service currently does not have any staff vacancies, so we do not have to rely on any agency staff.” This helped ensure people received their personal care and support from experienced staff who were familiar with their needs, preferences and daily routines. A member of staff added, “My shifts are well-coordinated by the service manager, and we have plenty of time off, so I’m not overworked.”

Staff received a mixture of e-learning and in-person practical and theoretical mandatory training and competency-based assessments which were relevant to their role and was routinely refreshed. In addition, staff received service specific training to ensure they could meet the needs of everyone who received a home care service. A member of staff told us, “The training we receive is always relevant and is continually refreshed so our knowledge and skills remain up to date.” A community-based care professional added, “If there is a new member of staff the service manager arranges for them to receive all the relevant training, they need to safely meet my client’s specific health care needs.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff received regular supervision, appraisal and competency checks. Where gaps in staffs’ knowledge and skills were identified, managers had plans in place to address shortfalls in staff training. A staff member told us, “I do feel supported by the service manager because we have regular supervision meets with them, as well as team meetings with my fellow co-workers.”

The provider operated safe recruitment practices and only suitable staff were employed to work for this provider. Recruitment processes included appropriate checks, induction and probation.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People’s flats were kept clean and staff carried out regular audits on cleanliness. One person told us, “With the help of staff my flat is kept pretty clean and tidy.” There were systems in place to help prevent and control the spread of infection. Staff followed good hand hygiene practices and used personal protective equipment [PPE] appropriately when they provide personal care and prepared food. Staff completed learning to understand about good infection control processes which included food hygiene and infection control training. They had access to resources and equipment to help them reduce infection risks when needed, which included adequate supplies of PPE. A staff member told us, “We have enough stocks of PPE including, gloves, masks and aprons.”

Managers conducted regular checks and audits on staffs’ infection prevention and control practices. The provider took appropriate action to address any safety concerns relating to infection prevention and control.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The provider’s medicines systems were well-organised and safely managed. Medicines were stored securely. Medicines were administered to people by staff who had been trained and assessed and competent to administer medicines. Care plans contained detailed instructions for staff to follow so they knew how people they supported to manage their prescribed medicines preferred them to be administered. Medicines administration records (MARs) were completed accurately confirming people received their medicines as prescribed by health and medical care professionals. Regular audits of medication practices were carried out by the management team.

The area manager and staff told us the service was adhering to ‘stopping over medication of people with a learning disability and autistic people’ (STOMP). Thisis a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications, an identified priority in the NHS long term plan.