Lifeways Paragon Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of a legal regulation in relation to good governance.

This service scored 58 (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 did not always make sure reviews of people’s care and treatment were effective. While regular reviews of people's needs took place, further improvement was needed to ensure reviews identified missing detail within care records and to ensure assessments were sufficiently detailed to ensure people’s individual risks were managed. For example, we found care plans relating to the management of skin risks were not always sufficiently detailed to reduce the risk of skin related harm.

The provider was responsive to our feedback and took steps to update some people’s care records before the end of the assessment.

The provider did not always plan and deliver people’s care and treatment with them in line with legislation and current evidence-based good practice and standards. The provider did not always follow good practice guidelines issued by The National Institute of Health and Social Care Excellence (NICE) or CQC in areas such the safe management of medicines and managing skin integrity risks. For example, when people had current risks relating to their skin, assessments did not show the provider had regard to nationally recognised guidance in terms of repositioning frequency or that they had considered the use of validated assessment tools.

Records did not always demonstrate people were supported effectively with nutrition and hydration. For example, where eating and drinking support plans directed staff to encourage healthier options, records did not always show this was taking place.

However, care plans generally reflected current best practice guidance in how to support people with a learning disability and autistic people. We were assured the provider had regard for CQC’s Right Care, Right Support and Right Culture guidance.

The provider mostly worked well across teams and services to support people. The provider understood their responsibility to work collaboratively with external stakeholders to ensure they had the information to deliver people’s care and support effectively. Records demonstrated advice from external health professionals was regularly sought and this advice was included in people’s care plans. For example, where people required modified diets to reduce risks associated with choking, we saw guidance from speech and language therapists was included in care plans to guide staff on how to deliver effective support and reduce risk.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People had annual health reviews and had regular access to external health professionals to ensure their health and wellbeing needs were met. Overall, people and their relatives felt confident staff worked effectively with health professionals. Comments included, “Staff will always phone for a GP if they are concerned and will involve me as well. Staff are very vigilant, recently they spotted an allergic reaction to the medication and they took [Person] to accident and emergency, we got [Person’s] medication changed” and “Staff help me to see the dentist and doctor.”

Although the provider routinely monitored people’s care and treatment, these reviews were not always effective. They did not always ensure records demonstrated positive outcomes and consistency in care, or they met the expectations of people themselves. For example, where people had risks associated with skin integrity and eating and drinking, records were not always accurate or complete. Although staff could describe how they ensured people achieved positive outcomes in these areas, records did not always evidence this. The recording shortfalls meant effective monitoring could not always take place and this increased the risk of people not having their needs met.

However, people and the majority of their relatives told us the care provided met their needs and they were generally happy with the support they received from staff.

Theproviderdid not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We saw evidence where decision specific mental capacity assessments had been completed following the correct legal processes. However, where decisions were made in people’s best interests, records did not always evidence significant others such as relatives’ or family members had been appropriately involved in decisions where applicable. This increased the risk decisions affecting people would not be made in their best interests.

However, our observations found staff sought people’s consent before delivering care. Feedback from people and their relatives confirmed this was common practice. Comments included, “They talk to her, ask for permission” and “As far as I have observed staff are respectful and ask permission before providing care.”