Lifeways Community Care (Taunton)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant the service was consistently managed and well-led.

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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

A shared vision, strategy and culture was held by the management team and staff which was increasingly focused on improving outcomes for people, promoting inclusion and embedding learning. Since the last assessment, professionals reported significant improvements in culture, governance and management oversight.

Staff demonstrated through their practice and our discussions with them, they understood the service values and described positive relationships with people, colleagues and managers. There was evidence of a stronger focus on person-centred support, independence and improving people's quality of life for autistic people and people with a learning disability.

Health and social care professionals described the service as person-centred and responsive to risks, while staff consistently spoke about supporting people to achieve goals and maintain meaningful lifestyles. Feedback showed morale had improved and staff felt there was now greater direction and support. Overall, the culture had improved and was moving in a positive direction, although further work was needed to ensure improvements were embedded.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders, managers and senior staff understood the challenges facing the service and had taken action to drive improvement. The registered manager demonstrated the skills, credibility and commitment needed to improve the service and deliver better outcomes for people. Since the last assessment, there had been significant improvements in management oversight, quality assurance and leadership.

Staff told us local managers and the registered manager were approachable, supportive and visible, and many said they felt well supported through supervision, training and team meetings. A staff member said there had been a definite improvement in management support and governance stating, “Lots more eyes on and lots more hands on.” During a particularly challenging time, staff discussed the commitment and professionalism of their colleagues to make a new person’s move to the service a success. The person’s family praised staff and the positive impact on their relative.

Professionals highlighted examples of managers and staff seeking advice, strengthening governance arrangements, reducing agency use and implementing action plans to improve accountability. Several relatives and professionals spoke positively about new leadership arrangements and acknowledged improvements in service quality.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff knew how to report concerns, understood safeguarding and whistleblowing procedures and told us managers were approachable and responsive. Complaints, concerns and feedback were used to identify learning and improvements, including changes to medicines management, recording practices and family engagement.

However, feedback was not consistently positive. A small number of staff described feeling under pressure or that concerns were not always dealt with in the way they would prefer. Some relatives also described difficulties understanding management arrangements during periods of change. Despite this, there was evidence leaders listened to concerns and were increasingly acting on feedback to improve the service. For example, staff had spoken up when they were concerned a person was potentially being supported to move to an unsuitable location; this was based on the staff members knowledge of the person and the importance of maintaining family contact. The registered manager had explored their concerns, and recognised the move was not in the best interests of the individual, so it did not taken place.

The provider had introduced accessible speaking-up resources, including an easy-read Speak Up policy, to support people to share their views. Most relatives felt able to raise concerns and said managers responded appropriately when issues were identified.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The service valued diversity and worked towards an inclusive culture for staff and people using the service. Staff came from a diverse range of backgrounds, and most staff told us they felt treated fairly, respected and supported. There had been an investment in training, supervision, induction and workforce development to improve staff experience and competency.

Staff described positive team working, supportive managers and collaborative cultures across many services. Some staff raised concerns regarding staffing arrangements and treatment of staff during organisational changes. However, feedback showed there was evidence staff retention, recruitment and workforce stability was improving.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Since the last assessment, governance systems had improved and supported better oversight of quality, safety and performance. Governance audits had developed, actions were clearer and incident analysis was being used to identify trends, themes and learning. The registered manager and their senior team had strengthened oversight of training, supervision, medicines management and care planning. These improvements needed to be embedded to ensure consistent, sustainable oversight across all the locations.

Professionals reported significant improvements in governance, quality assurance and management oversight. The provider was using audits, peer reviews, competency assessments and action plans to monitor performance and drive improvements. Agency staff use had reduced, helping improve consistency of care and record keeping.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

People were supported to maintain family relationships, access community activities and remain involved in local opportunities. The service worked in partnership with professionals, organisations and local communities to support positive outcomes for people. Health and social care professionals consistently described good communication, collaborative working and timely information sharing. For example, one said, “Excellent care for their residents and they are a pleasure to support.”

The service worked effectively with social workers, healthcare professionals, speech and language therapists, local authorities, housing providers and receiving services during transitions. These professionals told us staff followed advice, escalated concerns appropriately and advocated for people when required.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service demonstrated a clear commitment to continuous improvement and was progressing positively. Since the last assessment, governance had improved. Audits, incident reviews, complaints, stakeholder feedback and peer reviews were used to identify learning and improve practice. Lessons learned processes had been implemented following medicines recording issues, documentation concerns, staffing challenges and family feedback. These resulted in additional training, competency assessments, strengthened audits and clearer accountability arrangements.

Staff described improvements in governance and were able to explain changes made in response to learning. The provider had introduced peer location reviews, improved analysis of incidents and developed action plans to address concerns.

Professionals reported noticeable improvements in governance, culture and quality assurance arrangements. One said, “The staff take on board recommendations made by professionals to provide the best experience possible for the resident.”