Lifeways Community Care (Taunton)

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

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was previously in breach of the legal regulation in relation to dignity and respect. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

This service scored 50 (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 ensure people were consistently treated with kindness, dignity, empathy and compassion. At our last inspection we found people were not always referred to in a respectful way when staff recorded information about them. We found similar concerns at this assessment; the provider had failed to ensure improvements had been made.

One person told us they were, “Not allowed to step over a line” when a certain member of staff was on duty. The line related to an entrance to a room in their house. We discussed this with the registered manager who took immediate action to address this concern. We also observed a staff member responding inappropriately when a person requested a drink.

Some staff did not have a good understanding of why people acted in a certain way, and staff responses to people were not always appropriate. For example, on 1 person’s incident form it stated they threw an object and started “Screaming.” Staff responded by telling them the language they used was “Unacceptable” and staff “Would not tolerate this.”

An incident form in another service recorded where staff had not communicated appropriately with a person, this had been addressed with the staff member as part of the incident review process.

We discussed this with the registered manager who told us they had identified this as an area of learning for the team and had arranged for staff to undertake training and workshops.

We also observed positive interactions between people and staff. One person gave us positive feedback about their staff team. The person told us, “I do get on with them. [Name of staff] is very nice.”

People’s relatives were complementary about the staff supporting their loved ones. Comments from people’s relatives included, “All the staff are lovely”, “The staff are lovely and respect him” and “The staff are kind and caring.”

One professional told us, “Some carers have established strong relationships with the individuals over time and often exceed their responsibilities, they do go above and beyond.”

The provider did not always ensure people’s care, support and treatment met people’s needs and preferences. Care plans were of a mixed quality and people did not always have goals set to encourage independent living skills and to support decision making. Our observations found people were not always treated as individuals. For example, in 1 of the services in the sleep in room for staff there were 3 sets of drawers staff had their names on. This is not appropriate as staff were in a person’s home. We found entries in a person’s care records that stated they were, “Demanding to be taken out” and “Not listening to staff.” During our conversations with staff, 1 staff member referred to a person as being, “Very demanding.”

People’s care plans took account of people’s culture and needs and protected characteristics. One person told us they had set a goal to attend the Baptist church which had been completed. Another staff member told us how they supported a person to attend church weekly. Relatives told us, “The staff seem to enjoy their work and respect him as a person” and “The people who live there can do individual things rather than as a group.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Staff did not always support people to have control over their lives. For example, during our visits 1 person told us they wanted to go out, staff told them that today was their ‘home day’ and on that day they stayed in. The person had 2-1 staffing so there was no reason for them not to go out at that time. We discussed this with staff and the registered manager who confirmed the person did go out later in the day.

Staff did not always have a good understanding of how people made choices. For example, 1 person’s records stated that 1 of their choices had been to ‘choose to swear at staff.’ Another person’s records stated their choices were, ‘to shout, to swear and to throw tomatoes at me [staff].’ One person’s care plan stated they should, ‘apologise for any disruption caused’ following incidents.

Other people were supported to have control over their lives. People were supported to access opportunities in their community. This included, visiting local attractions, discos, shopping, national trust properties, swimming, charity shops and local towns and facilities. One person told us, they were fully involved in their support, explaining the choices they made every day both within their home and within the community. This person told us they were also involved in choosing the staff that supported them.

One relative told us, “My relative can choose what they would like to take part in. I think it makes my relative feel good to make their choices and ensures they are involved in their day-to-day life.”

Staff told us how they supported people’s independence. Comments from staff included, “We encourage independence and understand when they need support” and “We try and get people involved as much as possible.”

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Our observations of interactions between staff and people were mixed. During our visits staff were observed to not always respond to people's immediate needs. For example, 1 person asked staff for a drink and staff did not respond appropriately. People were not always responded to in line with their specific care plans and treated as adults due to staff understanding. For example, when 1 person was anxious their records stated they were asked to, ‘leave the table and calm down’, they were also asked to ‘go to their room.’ One staff member also told us they were considering whether to take a person out following an incident as it would, “Reward” them.

Other interactions were positive. Staff knew people well and were able to describe their needs and preferences.

The provider had systems in place to promote the wellbeing of their staff. Most staff felt supported by the management team and felt able to talk to both the service managers and registered manager if they had concerns. Staff received regular supervisions. The registered manager told us about the organisations employee assistance programme which provide support for staff. The registered manager gave examples of staff being nominated for internal awards for going above and beyond within their role.