Lifeways Community Care Limited (Bolton)

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Care plans outlined in the main how people preferred their care and support however, person-centred care was not always delivered.

People’s communication needs were met, and relatives told us staff understood people’s communication styles well. However, there was a lack of evidence how people who could not express themselves verbally were involved in decision-making in their care and in life in the home. No other methods of communicating with people had been explored.

People, and those important to them, could raise concerns and complaints easily and staff supported them to do so.

The service proactively supported people to remove any barriers to care and to support access to healthcare. The service worked in partnership with other professionals to meet people’s needs.

People did not have the opportunity to disclose their preferred end of life wishes. Care planning documentation for recording these were mainly blank. Any reasons why people might not want to discuss end of life care and support preferences were not documented.

This service scored 57 (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 although some aspects of people's care was person-centred and people's needs and preferences were being met in some areas, other areas needed improvement. For example, relatives told us people did not always receive person-centred care around activities, and did not always have their needs met around stimulation and accessing the community when needed.

Staff understood the importance of person-centred care, but were not always confident this was achievable, due to staffing resources. During our visits to 3 supported living projects, we observed good interactions between people and staff.

We observed occasions when person-centred care was not always achievable. Care and support plans needed reviewing more frequently and updating to reflect people’s changing needs and preferences.

Although some relatives felt staff were somewhat flexible around people's needs, we found staff couldn’t always be flexible around the routines for some people as staff were not always available.

Whilst staff were aware of people’s preferred care and support routines, we were told these sometimes depended on the availability of staff. One person had to access the community on different days each week, depending on when staff support was available.

Partners we asked for feedback judged that continuity of care for people needed to improve. Delivery of care in relation to one-to-one support hours formed part of the service improvement plan and was being monitored by commissioners.

Support plans were in place and provided staff with details about people's needs. They reflected the involvement of external health and care professionals involved in a person’s care.

Relatives told us people's communication needs were met and information was available to people in different formats to meet their needs. Comments included, "Staff have got to know [relative] well and they will communicate with [relative] according to what [relative] needs and will provide information in best way possible [so relative can understand].”

Long standing staff got to know and understand the people they were supporting, and recognised when they might be happy, in distress or in pain. For newer or temporary staff who might be less familiar with people’s different communication styles this was more difficult. Staff told us meal choices for one household tended to be made by a person who was able to make those decisions; it wasn’t clear if and how others had been involved.

Support plans outlined people’s preferred communication styles. When people were unable to express themselves verbally, staff had no access to any communication tools or other communication aids. There was little evidence of attempts to involve them in any household decisions, for example with meal planning and choice of activities.

Relatives told us people were listened to. Comments included, "[Relative] expresses what they want and staff respond" and "Staff always listen to [relative].”

Relatives told us they knew how to make a complaint. Comments included, "I know how to make a complaint", "We have contact numbers and know how to complain", and "I would contact the Lifeways office to make a complaint."

Staff and leaders we spoke with provided examples of when people had been listened to; complaints were dealt with as per the provider’s policy. An easy read complaints policy was available to people. It was envisaged the new electronic care planning system would encourage people to be more involved in their care.

There were processes in place to deal with complaints both internally and externally. Templates for gathering feedback from external partners were in place but had not been collected recently. Whilst some household / tenant meetings had happened others had slipped. The manager said these along with formal family meetings were scheduled in future plans to move the service forward.

Relatives told us staff supported people throughout the night as needed and had out of hours arrangements in place to keep relatives informed about any unplanned care. For example, staff supported people to access healthcare services in the night when required and kept relatives informed.

Staff in one property told us that staffing levels were a barrier to consistently good care; one person required 2 members of staff to support them with all transfers, due to mobility issues. Staffing levels during the night consisted of only one support worker; access to other staff was via the on-call procedure.

People were not always at the centre of their care and treatment choices. For people who were not able to communicate their choices it wasn’t clear what reasonable adjustments were in place. Any problems with trying to arrange necessary health appointments had not been flagged by staff.

Relatives told us they felt confident people and their relatives could express their views and it would be acted upon to achieve better outcomes for people. Comments included, "I feel staff would resolve any issues" and "We are encouraged to express our views and I feel the service would act upon any issues."

We engaged with 11 support workers during the inspection, and all felt confident; the induction and training had prepared them to support people who might experience any barriers to care.

The provider had processes to ensure people’s views were gathered in a variety of ways. People’s views of the service had last been sought in 2023; a large sample of these responses were from people not in receipt of a regulated activity. Some household meetings had taken place for people, but attendance and input at these was not documented.

Relatives told us plans for people's future had not always been explored and people had not been asked about their end of life wishes. Comments included, "End of life wishes has not been discussed with us and we would like to discuss this" and "End of life wishes has not been considered."

Staff told us this aspect of care was not routinely discussed with people due to the distress it might cause. There had been no exploration of how this sensitive subject might be broached with people.

Documentation was in place to record any end of life wishes and preferences, but these were blank in the support plans we reviewed. Where relatives had planned arrangements in advance, we saw basic information recorded in relation to funeral details.