Lifeways Community Care Limited (Nottingham)

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

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 72 (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.

The provider used a digital system to log accidents and incidents, and we saw that the registered manager reviewed these to identify any themes and trends. Any areas of concern, or good practice, were identified and shared with the wider staff team.

This practice of continued learning and ongoing improvement was embedded and supported on going good practice which improved the safety of people living at the services.

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.

The provider had a dedicated team who carried out assessments for people referred to the service. They worked in conjunction with the registered manager and ensured that the person’s needs could be met by the service, and compatibility with existing people was carefully considered to ensure people were suitable to live in the same environment and minimise the risk of any conflict.

People were engaged in the process of planning to move between different services as well as relatives and professionals.

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.

We saw where restrictive practice was being used, it was legally justified, proportionate, necessary and as a last resort. This was also documented in people’s support plans.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The information we reviewed showed that staff were aware of the MCA and what it required and followed the correct processes.

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a Deprivation of Liberty Safeguard (DoLS) was applied for through the relevant local authority. Any conditions related to DoLS authorisations were being met. The documentation supported that each DoLS application was decision specific for that person. We saw that the conditions of the DoLS had been met.

Staff were well-trained and effectively used safeguarding policies to protect those in their care. They had an understanding of individual risk factors for example, self-harm or potential aggression and implemented clear strategies to maintain a safe environment for everyone. We asked staff about how they kept people safe from harm and how they knew what to do. One staff member said, “With the people we support it’s all under control and all planned, we have it [guidance], step by step. You read the support plan, and you know how to support that person.”

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.

We saw people were supported to do the things that mattered to them including holidays, education and outings which were risk assessed. For people with limited verbal communication care plans emphasised people’s preferred means of communication to support their understanding and ability to make informed choices by providing information in a way that they understood.

We saw examples of positive outcomes for people including support one person received with independent travel, how this was planned, how the person was involved as well as other professionals engaged in the process.

Risks were assessed and mitigation in place which kept people safe whilst promoting them doing things they wished to do.

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

We saw good examples of issues that had been identified and addressed including issues with hoists and slings and ensuring this equipment was checked and safe for people to use.

Lifeways Community Care Limited Nottingham provides supported living services. This means people’s care was separate to their tenancy and maintenance and repairs were the responsibility of the housing provider. We saw that staff carried out health and safety checks and engaged people where possible in maintaining their home environment as well as where issues had been reported to the housing provider and escalated for them to address to support with maintaining a safe living environment for people.

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.

We reviewed documentation that evidenced staff received regular supervision to support their development. Staff received an induction, they shadowed experienced staff and training was completed, including person specific training, to ensure staff had the right skills to safely support people. Staff confirmed they felt supported and were encouraged to undertake training and develop their skills and knowledge. One staff member told us, “I felt the [training] here was really good, very in depth especially the ones we go to in person they are very interactive, did my basic life support yesterday.”

The provider followed a safe recruitment process. Interviews were values based to ensure staff were well suited to the role. People were actively engaged in the recruitment of staff for their services. We saw documentation that supported staff being matched to people based on people’s likes and preferences. We saw feedback from a person supported that demonstrated they had found this staff matching process particularly valuable as they felt they had been able to better communicate with a staff member that had shared similar life experiences that was recruited.

These processes ensured people were supported safely by appropriately trained staff who were matched to the needs of people to enable them to work towards and achieve their aspirations and potential.

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.

The services assessed were found to be clean, staff had access to appropriate personal protective equipment, and the provider had a current infection prevention and control policy to guide staff. Staff ensured people were supported with their personal hygiene and clothes were clean. We saw evidence of sensitive conversations with people regarding them engaging in personal care and found that these conversations had positively influenced people’s engagement in personal care tasks.

These measures supported to keep people safe from the risk of infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

We found protocols for ‘as required’ medicines, for example paracetamol, did not always provide clear guidance for staff on the dose people should receive. The registered manager addressed this promptly and all protocols were reviewed and amended to provide clear guidance for staff.

At one of the homes, we found emollient cream stored inappropriately and not labelled with the date of opening. It is important that items are labelled with the date they are opened to ensure they are not used beyond their expiration date from opening. This was discussed with the manager and senior support worker at the time.

The providers policy and standard operating procedure did not provide clear guidance for staff. This was escalated to the providers policy team by the registered manager at the time of the assessment. Staff had all received appropriate training and competency assessments for administering medicines which mitigated the potential risk.