Lifeways Community Care Limited (Bolton)

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People’s choice and control over their care was not always promoted. People who required support from staff to engage in hobbies and activities had limited choice about when they could go out or engage in activities, due to a lack of appropriate staffing arrangements.

People were encouraged to be independent where possible.

Staff took the time to understand people’s individual communication styles and develop a rapport with them. Staff could recognise signs when people experienced emotional distress and knew how to support them to minimise the need to restrict their freedom to keep them safe.

Relatives told us staff treated people with dignity and respect.

Feedback from staff and leaders was mixed. Whilst staff were appreciative of local managers, they felt isolated from the wider company. Not all service managers had team leader support; they told us this added further pressure and negatively impacted their wellbeing.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us staff treated people with dignity and respect. Comments included, "Staff are respectful with [relative] and with me", "[Relative] is treated with dignity" and "Staff treat [relative] with dignity all the time."

People and relatives told us staff were kind and caring. Comments included, "Staff are very kind and caring", "Staff are very kind and caring, they [staff] spoil [relative], staff are fantastic" and Staff are pleasant, kind and caring."

Relatives told us staff gave people privacy. Comments included, "[Relative] has access to their privacy" and "[Relative] is always provided with privacy."

Staff were respectful towards the people they supported. Staff were genuinely concerned for people and explored ways in getting to know people better, especially when they were new to the service. One member of staff described ways they had tried to make a new person to the service feel more settled and comfortable. Families were very complimentary.

Feedback we received from partners was positive. Staff tried their best for people despite being faced with numerous challenges.

We observed staff trying to do their best for people, sometimes in difficult circumstances and with high workloads. Service managers tried to ensure that care remained compassionate and dignified; some were able to flex staffing levels to help with this. Staff considered teamwork was really good; there was respect shown for other colleagues, and local service managers. Equality and dignity training were aspects of mandatory induction training undertaken by all staff.

Relatives told us people could make day to day choices. For example, relatives told us people could choose when they would like to have a shower or what food or drink they would like. Comments included, "Staff know what [relative] wants and when they want it" and "Staff know about [relative's] choices."

Relatives told us people's social needs were met. Comments incudes, "Staff bring [relative] to see me [I have trouble getting out]" and "Staff are very welcoming, you don’t need to make appointments to see [relative].”

Whilst staff tried to treat people as individuals, routines were sometimes dictated by staff rotas and the availability of staff. Bedtime and rising routines for 1 person had to happen when 2 members of staff were on duty, due to the use of a hoist. This meant that the person was limited when they could get up and go to bed. This did not represent good person-centred care and we identified a breach in regulation.

Feedback we received from partners was mainly positive. They recognised staff tried to go the extra mile on occasions for people. A social care professional told us staff had taken one person on holiday, a place they had wanted to visit; the experience had ‘enriched’ the person’s life.

We observed staff being kind and courteous to people. Staff were patient and used appropriate language when communicating with people. They did their best to provide individualised care and support to people, whilst being faced with challenges.

Rotas were in place and staffing levels were based on people’s needs. Whilst personal care needs were met, staffing levels did not always allow for people to be supported away from the home on certain days, or at a specified time. On occasions service managers were able to spend time as cover staff in the home but this was not always possible due to their workloads. We were made aware that at least 2 people had opted to employ a Personal Assistant (PA), independent of Lifeways Bolton Limited. This ensured they were supported in the community at times they preferred. One person had a season ticket for a local football team and attended games with their PA.

Relatives told us people could not always take part in accessible activities and access the community. Comments included, "[Relative] has been wanting to go on holiday for some time and this has not happened yet", "There are no in-house activities and no stimulation indoors", "They don't have enough staff who can drive, so [relative] cannot go out often" and "Every time I visit [relative] is just sat in their wheelchair in their bedroom." Relatives told us they can visit people as they wished. Comments included, "Staff are very welcoming when we go to visit". Relatives told us people were encouraged to be independent where possible. One relative told us, "[Relative] does their own cooking and cleaning supervised, staff encourage them with their independency, and they have individual tasks allocated to do."

We received feedback from 11 support workers during our onsite visits and telephone calls about how they supported people to be independent. Some houses managed this better than others. We had a discussion with the manager onsite and reviewed 5 care plans in total. People were not always in control of their own routines and access to the community was hampered at times. People were not always able to enjoy activities of their choice or at regular times due to staff availability or lack of appropriate skills within the staff team, such as driving. In another service one person was supported to have a holiday. Suitable accommodation was found in the same area near to where a close relative lived, so they were able to meet up.

We visited 3 supported living houses and observed care and support being delivered. Where people were less dependent on staff, they were able to come and go as they wished, if it was safe for them to do so. Some people had paid employment or voluntary jobs.

Where people required increased support from staff, activities sometimes suffered. We saw a person’s log from a car which showed it had been used 5 times in the last 6 months. We checked the care plan which reflected that the person enjoyed going out in the car, but this wasn’t always possible.

Whilst we had no concerns about the safety of the care people received, this was not always person-centred or in line with care plans.

Activity planners were in place and outlined places and activities people had chosen to do. We reviewed these planners for people in receipt of a regulated activity, who predominantly needed support from staff. We noted that people were not always in control of their routines. For example, we noted Wheels for All was included on 2 people’s weekly activity planner as both enjoyed the activity. Staff we spoke with told us weekly attendance was not always possible, either due to staffing levels in the service or a lack of drivers. It was not clear from records we saw how often this occurred or the impact on people.

We noted there had been occasions when people’s weekly routines had changed, either by choice or because staff support was not available. These changes were not documented or explained in care plans. This did not reflect good person-centred care and we identified a breach of Regulation 9, person-centred care.

Relatives told us staff understood people's communication styles and needs. Comments included, "Staff know [relative] well" and "[Relative] communicates with staff by making signs, staff know [relative] well."

Relatives told us staff responded to people's needs accordingly. Comments included, "[Relative] can get across their daily needs, such as if they want a drink or need the toilet they can express that, and staff respond."

Staff we spoke with tried to respond to people’s immediate needs in a timely manner. This was sometimes hampered by staffing levels, particularly in services where people required a lot of support from staff.

During our visits we observed staff responding appropriately when people needed their support. We saw a person was watching television when their weekly planner indicated an activity. We queried this and was told it was their choice to stay indoors, although this was not documented on the weekly planner.

Feedback from staff and leaders was mixed. Whilst staff were appreciative of local managers, they felt isolated from the wider company. Staff worked long hours and people in some houses were more dependent on staff, due to advancing age or more complex needs. Not all service managers had team leader support; they told us this added further pressure and negatively impacted their wellbeing.

There were processes and procedures in place for staff to access to help with their wellbeing, although not all staff we spoke with were aware of what was available. Staff were supported in the workplace with supervisions and annual appraisals.