Lifeways Community Care Limited (Leicestershire County)

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

This means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this newly registered service. We rated this key question as Inadequate. This meant people were not treated with compassion and kindness, dignity and respect.

This service scored 25 (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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Most relatives told us the staff were caring and compassionate and treated their loved ones with dignity and respect. However, one relative told us, “The manager has been in place for 2 years now, and the staff need a better mind set when caring for my relative. Staff attitude adjustments are required”.

Staff understood their responsibilities to ensure peoples dignity and privacy was upheld. One staff member told us, “We make sure we don't speak to people about personal things in front of other tenants. We close the bedroom door and curtains when we're providing personal care”. We observed some kind and person-centred interactions with people at some residences we visited. However, at other residences, staff lacked skills in meaningful engagement with people. At times we observed people were ignored or staff did not attempt to initiate positive and meaningful engagement with them.

People told us they have been shouted at by staff. One person said, “Staff are okay, I don’t like the ones that shout, there are some that shout at me and I don’t like that". The person and some staff confirmed that not all staff communicated with people respectfully. We escalated these concerns with external agencies.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Some people’s care records provided staff with guidance about their individual cultural and religious needs. For example, a person's care plan detailed their cultural and religious needs and preferences, and how this impacted on their care and support needs.

We found other people’s plans lacked sufficient detail and relevant information regarding people’s complex communication needs. People who were nonverbal and required staff to understand their expression through presentation and the use of Makaton signs, did not have detailed information in their care records to ensure staff could use individual preferred communication techniques. Staff also lacked training in Makaton and signing to ensure people could express themselves and feel listened to. This meant people did not have their preferred method of communication assessed and staff lacked guidance on how to support people with meaningful interactions or effective communicative distraction techniques.

In some residences staff engage with people more frequently and purposefully when people approached them for conversation or requesting direct support. Staff were positioned away from people in the kitchen. We observed people with profound communication needs missed out on meaningful and purposeful engagement.

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

Peoples care records had not been regularly reviewed and updated to ensure people received the care and support based on their personal preferences. People’s relatives told us there was a lack of engagement and forward planning to ensure activities were offered in line with people’s interests. People were not always able to spend time with those important to them to celebrate key events. One relative said, “We asked if we could throw a 60th birthday party for [person], the manager said No. It would impact on the others living there. We said we would do everything; the staff wouldn't have to do a thing. No, she said, if you want one you can have it in the garden. It was for the end of November”. Therefore, some people's rights to maintain relationships and celebrate important milestones with families were not respected or supported.

People did not have equal opportunity to develop new skills and new experiences. Some people had the chance to develop skills such as gardening. However, some people less able to share their goals or ambitions had no progression plans in place to ensure they were supported to develop or maintain new skills or experiences.

Although care records identified peoples likes and dislikes, these had not always been updated or reviewed. Not all staff were able to tell us about the people they were supporting. One person raised concerns with us about significant times during the week they were left without support. The person said, “I wake up early now its lighter and I have to wait for staff to be available, and I need the toilet. This makes me angry. I need help from staff to keep clean." This demonstrated people did not always have choice and control over their care.

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

Some relatives told us the staff team did not respond to decline in health or changes in need. One relative told us, “Staff are not proactive. I was told [Name] been wetting the bed. It happened twice. I asked if they had a urine infection. Yes, they did. However, this was prompted by us and not by staff”

People who required assistance with personal care, meal preparation and support with emotional distress did not have their needs met or responded to in a timely manner. One person told us they had no scheduled support during the weekends, we confirmed this with staff and reviewed the staff rota.

Staff told us they had raised concerns they were unable to provide timely care for the person, but these had not been acted on. The registered manager told us people were receiving the hours that they were commissioned for, however, despite staff and the person raising concerns the registered manager had not completed a review of the staff deployment or taken action to ensure people were not left without support at key times. This led to loss of dignity for person who told us of their distress in not being able to manage their personal care needs. There was increased distressed behaviours, including physical incidents, in response to a lack of physical and emotional support and reassurance. The lack of effective staff deployment meant staff did not respond to the persons immediate needs. This meant the person was at risk of harm from neglect, unnecessary restrictions and potentially avoidable distressed behaviours.

The provider did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

A lack of effective systems and processes to ensure effective staff support and oversight meant staff were left feeling unsupported without direction or guidance to ensure they were delivering safe person-centred care.

Some staff told us they felt unsure they were doing the right thing at times despite their requests for support and guidance, particularly regarding the implementation of an electronic care planning system. One staff member told us, “We had training 6 months ago for the nourish system and we are still not using the systems as there is no information on there, now it’s been that long, when you go on it to use it, it doesn’t correspond to any support the people get here. It asks you to complete checks for people that aren't relevant to them or their needs. There is no support with this new system I have raised this in an email with the service manager but haven't had a response”. This meant people were at risk of receiving care which had not been adequately assessed or reflective of their personal preferences and staff were not supported or guided to use the providers care planning systems and processes. The registered manager confirmed they had not achieved the provider timescales in which the electronic care planning system should be embedded in the service which had impacted on out of date staff team training to ensure the care planning system can be embedded effectively.