27 May and 9 June 2015
During a routine inspection
We inspected Lifeways Community Care offices in Croydon on 27 May 2015 and visited people using the service on 9 June 2015. The inspection was announced 48 hours in advance.
Lifeways Community Care is a service which provides personal care to adults who live in supported living accommodation in London and the South East. At the time of our visit there were 45 people using the service, many of who had complex health and communication needs.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they were safe. Staff had good knowledge about how to identify abuse and report any concerns. People had risk assessments but these were inadequate and did not give staff sufficient information on how to manage the risks identified. Some people’s risk assessments had not been reviewed or updated since the initial assessment.
Staff arrived on time and stayed for the allotted time. People were cared for by a sufficient number of suitable staff to help keep them safe and meet their needs. Staff were recruited using an effective procedure which was consistently applied.
There were appropriate arrangements in place for the ordering, storing, administration and recording of medicines. People told us they received their medicines safely.
Staff knew the people they were caring for well and people were satisfied with the quality of care they received. However we were concerned that people’s needs were not regularly reviewed. Their care plans were not always up to date and therefore might not reflect their current needs.
Staff were not adequately supported by the provider to deliver effective care. Staff did not receive regular training, supervision or appraisal. Some staff did not receive an induction to make sure they had the skills they needed before they started to work at the service.
The registered manager and some staff had received training in the relevant requirements of the Mental Capacity Act 2005 and understood how it applied to people in their care.
Staff supported people to have a nutritious, well balanced diet. Staff worked with a variety of healthcare professionals to support people to maintain good health. However, people’s health action plans and hospital passports were either incomplete or were not updated. This meant there was a risk that external healthcare professions would not be fully aware of people’s health conditions, current medication or communication needs.
People told us and we observed that they were treated with respect and staff were kind and caring. People were supported to be as independent as they wanted to be. Staff encouraged and supported people to have advocates.
Staff understood their roles and responsibilities. People felt able to contact the service’s office to discuss their care. The registered manager was recently appointed and had worked in the adult social care sector for many years. They understood what was necessary to provide a quality service and had started to implement their plans to improve the service. Staff felt supported by the registered manager.
There were systems in place to assess and monitor the quality of care people received which had identified some but not all areas of the service which required improvement. Where areas for improvement had been identified an action plan was in place which the management and staff were beginning to implement.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to how the provider assessed people’s needs, supported staff and managed the service. You can see what action we told the provider to take at the back of the full version of this report.