Lifeways Community Care (Taunton)

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 – 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 Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 service assessed and reviewed people's health, care, wellbeing and communication needs with them. Care planning and assessment processes had improved, with increased focus on reviewing care plans, risk assessments, healthcare records, positive behaviour support plans and mental capacity documentation to ensure records reflected people's current needs. Staff feedback confirmed care plans and risk assessments were regularly reviewed and reflected people's needs.

Health and social care professionals told us staff knew people exceptionally well, including their likes, dislikes, communication preferences, situations which might cause them distress and warning signs of deterioration. We reviewed support plans which contained detailed information about people's communication needs, daily routines, health conditions and the support required to maintain their wellbeing.

Staff used a range of communication approaches, including visual schedules and objects of reference, to understand people's views and support decision making. One professional told us, “The manager and staff knew them exceptionally well – all of their likes/dislikes, mannerisms, non-verbal communication, triggers, patterns of behaviour, warning signs of deterioration, positive strategies that work to support.”

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.

Relatives and staff gave examples of gradual and personalised approaches to achieving goals, including supporting people to access healthcare procedures, increase independence and manage anxiety. Care plans incorporated specialist advice from healthcare professionals and included guidance relating to epilepsy, dysphagia, nutrition, positive behaviour support, communication and medicines management. Staff used recognised approaches including positive behaviour support planning to support people safely. Records showed staff received training appropriate to people's needs, including supporting autistic people, supporting people with a learning disability, dysphagia, epilepsy, moving and handling and behaviour support.

We saw examples of specialist guidance being followed, including seizure management plans, dysphagia support, mental health support and positive behaviour strategies. One professional told us staff were “entirely person-centred and responsive to concerns and risks.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service worked well across teams, services and partner organisations to support people. Professionals described positive communication and information sharing and confirmed staff followed advice and acted on concerns. We saw evidence of effective partnership working with social workers, specialist nurses, speech and language therapists, local authorities and healthcare providers.

Staff worked collaboratively during transitions between services and shared assessments, support plans and risk information to maintain continuity of care. Records showed people moving between services were supported through transition plans, visits to new services, family involvement and regular meetings with receiving providers.

Professionals told us staff escalated concerns appropriately and liaised with healthcare services when people's needs changed. One professional said communication was consistent; concerns were raised promptly and supporting information was shared appropriately.

Staff described working closely with GPs, psychiatrists, housing officers and social care professionals to achieve positive outcomes. Although some professionals identified historic challenges associated with staffing instability and communication, they reported improvements in governance, oversight and information sharing.

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.

The service supported people to manage their health and wellbeing to maximise independence, choice and control. Staff recognised when people's health deteriorated and took appropriate action, including referrals to healthcare professionals and support with accessing appointments.

Records showed health appointments and outcomes were recorded, annual health checks were completed and people had access to specialist services when required. Professionals reported significant improvements in how health needs were monitored and managed, with better organised health records and greater managerial oversight. One said there was a “very good working relationship.”

Staff supported people to participate in meaningful activities, develop independence skills and maintain healthy lifestyles. Examples included supporting people with shopping, physical activity, healthy eating, weight management and community participation. A social worker told us staff were quick to identify concerns relating to both physical and mental health and responded promptly. Relatives described people being supported to attend appointments and receive timely healthcare interventions when needed. The service promoted healthy lifestyles and supported people to maintain and improve their health and wellbeing outcomes.

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.

The service routinely monitored people's care and treatment and had improved how it used information to improve outcomes. Since the last assessment, governance systems had strengthened, audits were more structured and incident analysis was being used to identify themes, trends and learning.

Leaders used quality assurance systems, supervision, audits and oversight tools to monitor care delivery and identify areas for improvement. Professionals reported improvements in governance, management oversight and quality assurance arrangements. Staff were able to describe changes made following incidents, complaints, medicines errors and feedback.

Records demonstrated learning had been embedded through additional audits, competency assessments, supervision and targeted action plans. Positive outcomes were evident, including improved consistency of support, reduced agency use, better healthcare oversight and progress towards personal goals. A family member said there had been a “marked improvement in her mood recently and she seems genuinely happy.”

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

The service sought to respect people's rights around consent and involved people in decisions about their care and treatment. People's care records included information about how consent was sought, how people were involved in decision making and how family members or representatives were consulted where appropriate. We saw evidence of mental capacity assessments and best interest decision-making processes being completed where required.

During the assessment, action was taken to address an environmental restriction which was no longer needed. While improvements were still needed to fully embed best practice documentation, people's rights around consent were respected and they were supported to be involved in decisions affecting their lives.

Staff supported people to make everyday choices using communication methods tailored to their individual needs, including visual schedules. We met people who had decided how to spend their day, for example going out for the day to a place of their choosing.

Staff and relatives described people being supported to make choices about activities, meals, personal routines, healthcare appointments and daily living arrangements. Staff understood the importance of best practice. For example, 1 staff member told us they always assumed people had capacity unless assessed otherwise and ensured choices remained person led.