Lifeways Community Care Limited (Nottingham)

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

Effective – 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had a team of people who focussed on assessing people prior to them moving in to ensure they were well suited to the physical environment as well as considering compatibility if other people lived at the service. We saw assessments were detailed and captured people’s wishes and needs, capacity, communication, and others involved in their life.

People’s history was included in care plans which had been gathered from the person, relatives and professionals. This provided a holistic view of the person including any exposure to trauma to ensure it was considered in all their care planning.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were supported and encouraged to maintain relationships and develop relationships with others. The provider and services arranged activities across the area involving other services were arranged by an activities committee which supported with bringing people from different services together to foster the development of friendships.

We spoke with a person about their desire to have a partner. The person told us how staff had supported them to find a partner using the internet safely. They said, “They’re [staff] not like telling you what to do or things you don’t want to do.” Staff understood what was important and what mattered to people. One of the team leaders told us about what one of the people valued since they had moved to supported living from residential, “[Name] found there were so many restrictions [where they lived previously], like when people got up and that’s one of the things they enjoy living here as it empowers them. We offer them choices of what [name] could do but ultimately, it's their choice and we respect that.”

Care plans contained detailed information on how best to support people to ensure what was important and what mattered to people was included in their day-to-day support.

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 feedback we received from external professionals was inconsistent with some feeling communication, engagement and information sharing between the staff and them was positive and others feeling communication was sometimes delayed, staff could not always promptly provide them with the information requested and one professional described staff response to their feedback as “defensive”. This was discussed with the registered manager who advised what action had been taken and further planned action to improve on this.

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 were supported to access the GP, dental services, opticians as well as specialist services like sexual health clinic, speech and language therapy and occupational therapy.

We spoke with the manager at one of the services about supporting people to access well man/woman clinics as we didn’t see any evidence of this. They followed this up and sent follow up documentation to evidence this.

Staff were knowledgeable and support plans contained information on people’s specific health needs and anything in place to maintain people’s health and wellbeing. For example, one person who was at risk of choking, staff knew how best to prepare the persons food and prompt them with eating to reduce the risk of them choking.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

It was not always clear from daily records how people were supported as records were not always detailed or completed appropriately. However, we did see examples of the registered manager and service managers monitoring of people’s care and treatment and things that had been implemented to support with improving outcomes. For example, we saw team meeting minutes which detailed the use of behaviour monitoring charts and the difference between this and incident reports.

All services had a “proud” folder which documented through text and photographs the achievements of people supported. The folder evidenced people’s engagement in setting and achieving goals and ambitions and working to their strengths to achieve them.

Outcomes and achievements were celebrated, and the registered manager had oversight of this and kept a central folder at the area office to showcase these achievements. This meant setting goals with people and supporting them to reach these goals was an embedded way of working promoting positive outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We saw that capacity assessments were integrated into support plans and understood by staff. In instances of incapacity, best-interest decision-making was collaborative, involving the person, their relatives, and advocacy services, with all outcomes documented in people’s support plans Observation of staff engagement with people showed they communicated with people using their preferred method of communication including using signs, language that was simple to understand, and gestures/pointing to things.

These measures supported people’s choice and ensured, when people were unable to make a decision for themselves, that the right people were involved in decision making so that it was in line with the persons wishes and preferences and made in their best interests and within a legal framework in line with the Mental Capacity Act 2005.