Lifeways Community Care (Taunton)

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 – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

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 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 service promoted a positive culture of safety and had improved how it learned from incidents and concerns. Since the last assessment, governance systems had developed and effective incident analysis was used to identify themes and trends. Team meeting records showed managers discussed documentation standards and learning from incidents to improve practice. This addressed the incident and accident records which did not consistently record outcomes, showing this area of practice was work in progress.

Staff demonstrated learning from incidents and could describe changes made to improve practice. Leaders had introduced lessons learned processes following medication recording errors, documentation concerns and family feedback, resulting in additional training, competency assessments and strengthened oversight.

Staff described feeling more supported and professionals reported improvements in governance and quality assurance arrangements. Staff and professionals told us the service was improving and moving in a positive direction. Professional feedback described greater management oversight and a more proactive approach to responding to concerns.

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 service always worked with people, relatives and partner organisations to support safe care and continuity when people moved between services. We saw evidence of detailed transition planning for people moving to new services, including visits, family involvement, sharing of information and joint working with receiving providers.

Health and social care professionals told us staff recognised changes in people's health and took appropriate action, including contacting health professionals and local authorities when people's support needs changed. Records showed people were supported to access healthcare services and outcomes from appointments were recorded. People continued to access hospital support when required, and families remained involved in planning where appropriate. One professional described the service as responsive to concerns and risks and said staff escalated issues promptly. Improvements in record keeping and reduced agency staff use had also reduced risks to continuity of care.

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.

Some safeguarding notifications and incident records lacked sufficient detail regarding actions taken and outcomes, meaning oversight could have been stronger in some cases. Despite this, professionals confirmed concerns were addressed appropriately and records demonstrated improvements in safeguarding oversight since the previous assessment.

The service always worked to protect people from abuse, avoidable harm and neglect. Safeguarding processes were appropriate and referrals were made when concerns arose. Staff understood their responsibilities to raise concerns, and safeguarding notifications were completed when needed. Relatives consistently told us people were safe.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care settings, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. Documentation was well completed in a timely manner to help protect the rights of the people supported by the service.

Staff described how they would report safeguarding concerns and access whistleblowing procedures. People benefitted from support plans, risk assessments and behaviour support plans that considered safety whilst maintaining independence.

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.

The service worked with people to understand and manage risks whilst supporting them to maintain independence and achieve positive outcomes. Risk assessments and positive behaviour support plans contained personalised guidance to help staff understand risks and support people safely. Records demonstrated consideration of specific risks including dysphagia, pica, epilepsy, nutrition, communication, restrictive interventions and community access.

There was a policy for extreme weather conditions, and staff could tell us how they kept people safe but without impinging on their choices. For example, 1 person loved to walk on a daily basis, so their support staff set off much earlier with them on their chosen route before the temperatures became potentially unsafe.

Health and social care professionals told us staff knew people exceptionally well, including their responses to specific situations, communication styles and warning signs of deterioration. Relatives described people being supported to make choices, access community activities and maintain independence whilst risks were managed. Staff described how they used visual schedules, communication tools and person-centred approaches to help people make decisions.

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

Environmental conditions were improving as part of better governance on properties and a recognition of people’s changing needs. Lifeways had identified 1 location as no longer being suitable for the people living there. For example, the upkeep of the building and décor had not been addressed by the landlord. The registered manager and staff acknowledged the decision to help people to move to more suitable accommodation had been complex, particularly due to the multi agencies involved.

A new scheme manager at another location had tackled long standing environmental issues to benefit the people living there. A relative raised concerned about the arrangements for 1 person to have a bath. The registered manager said other options would be looked at as the current set up was not a viable long-term solution.

Most relatives and professionals described environments as clean, welcoming and well maintained. Positive feedback highlighted improvements to the physical environment, renovations and better home presentation. For example, staff explained how people had been involved where possible to choose colours and influence the appearance of their home, which was owned by a landlord separate from the service provider. The provider had business continuity arrangements, environmental audits and infection control audits in place.

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.

Since the last assessment, staffing arrangements had improved with the service generally ensuring there were enough skilled and competent staff to meet people's needs. Agency staff use had reduced significantly, helping improve continuity and consistency of care. However, there remained some staffing challenges. Some staff and professionals referred to staffing pressures, turnover and occasional shortages. We did not see a negative impact on people’s support in relation to staffing levels during the assessment.

We saw people at ease with staff with some sharing humour. Staff showed a genuine commitment to support people’s well-being. Relatives said, “The staff team are excellent” and “We have a great team. They are brilliant with her.”

Improvements in recruitment, inductions and retention had strengthened staffing stability and reduced risks to people. Recruitment processes included employment checks, references, right to work checks and DBS (Disclosure and Barring service) verification. Staff described positive induction experiences, training opportunities and supportive management. Professionals also reported reduced reliance on agency staff and more stable leadership. Records showed staff received supervisions and appraisals and managers used dashboards to monitor training compliance with action taken if staff did not complete mandatory training.

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 service assessed and managed the risks associated with infection prevention and control. Infection control audits were completed and staff had access to infection prevention training and competency assessments. Relatives described people’s living environments as clean and well maintained. Staff told us they wore protective equipment such as gloves, followed cleaning schedules and involved people in maintaining their homes where appropriate.

The provider also produced accessible guidance on managing environmental risks, including heat and sun safety. Infection control and audits demonstrated ongoing monitoring with governance arrangements supporting continued oversight of infection prevention practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Positive changes had been made in response to governance findings, which addressed areas for improvement. For example, a manager at one of the locations had worked closely with health professionals to address an error in the prescribing of 1 person’s medicines. They had also instigated changes in ways medicines were signed in and out to help create better oversight and spot potential risks. The provider responded positively by retraining staff, repeating competency assessments and introducing stronger auditing arrangements.

People received their medicines safely and relatives raised no significant medication concerns. Staff received medicines training, competency checks and annual observations. The provider had systems for medication audits, storage and administration records, and examples of clear medication guidance within care records.