Lifeways Community Care Leicester (West)

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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. We rated this key question as Requires Improvement. This meant there were shortfalls in people’s care, support and outcomes.

This service scored 46 (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 people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The service did not consistently assess or review the needs of people in a timely or person-centred way. Assessments and care records lacked depth and did not always reflect individuals’ communication styles, sensory preferences, or behavioural support needs. Care records failed to capture the unique strengths, aspirations, and risks associated with each person.

Relatives told us there was limited involvement in assessment processes, and people supported were not always given meaningful opportunities to contribute. This meant people's care was not always holistic, regularly reviewed, and co-produced with people, families, and professionals to promote independence, choice, and wellbeing.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

People were supported to meal plan and complete regular shopping trips to make their own meals. Care records included their cultural preferences and likes and dislikes.

However, feedback from stakeholders raised concerns that evidenced based plans and assessments were not consistently being followed by staff to ensure people received safe care. The service failed to deliver care and support in line with evidence-based practice for people with learning disabilities and autistic people who experience distressed behaviours. Behaviour support plans were either missing or lacked meaningful detail, and staff did not demonstrate understanding of recognised approaches such as Positive Behaviour Support (PBS). Responses to distressed behaviours were inconsistent, reactive, and at times escalated the situation, placing people at risk of emotional harm and unnecessary restriction.

There was no evidence of a PBS methodology embedded within practice or within care records for people to ensure a proactive, active or reactive practice, and staff had not received adequate training to recognise the triggers or communication needs of individuals. People were not supported in ways that respected their autonomy, sensory preferences, communication or emotional wellbeing. The absence of structured, therapeutic approaches undermined the principles of Right Support, Right Care, Right Culture and failed to promote safe, person-centred care.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The provider used an electronic care planning system which staff used to communicate relevant information, concerns or changes in need.

Staff told us they had good working relationships with services such as local pharmacies, community nursing teams and GP surgeries. However, multi-disciplinary input was not routinely sought and acted upon by the provider or embedded in care reviews, and people supported were not always involved in discussions about their care. This lack of joined-up working undermined the delivery of person-centred, evidence-based support and contributed to avoidable distress and unmet needs. A lack of systems for collaboration to embed a culture of shared responsibility across teams and services meant delay in ensuring people were supported effectively and actions were taken timely to meet deterioration or changes in need.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were supported to attend regular health appointments and have an annual health check with their GP. However, the service did not consistently support people to live healthier lives. Health action plans (care records which support people to manage their health conditions) were incomplete or not regularly reviewed, and there was limited evidence of proactive support around nutrition, physical activity, or preventative healthcare.

Staff lacked knowledge of people’s individual diagnosis, how this impacted early signs of health deterioration, and referrals to specialist services, such as speech and language therapy or mental health support were often delayed. While some staff showed commitment to promoting wellbeing, this was not embedded across the service.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

The service did not consistently monitor or evaluate outcomes for people in a meaningful or person-centred way. Systems for tracking progress against individual goals such as increased independence, improved wellbeing, or community participation were underdeveloped. For example, people who required social stories to support understanding and embed learning and improved emotional well-being were inconsistently used by staff. Although examples of social stories were shared by the registered manager, staff confirmed they were not frequently used in line with people’s assessed needs. Staff lacked knowledge and understanding of how to use social stories with people who required them. This meant the provider lacked robust systems to monitor outcomes, ensure goals were meaningful and tailored, and embed a culture of learning and accountability that reflects the principles of Right Support, Right Care, Right Culture

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

There was a lack of clear processes to support lawful decision-making, and documentation relating to consent and mental capacity was missing for some specific decisions. In some cases, restrictions were placed on people without appropriate authorisation or evidence that these had been agreed in their best interests. For example, a person had a lap belt insitu when residing in their wheelchair. The registered manager had failed to ensure this was applied for authorisation within the Court of protection process. We asked for the best interest documentation; however, this was not provided. This created a risk that care was not delivered in line with people’s rights, preferences, or legal safeguards.