Lifeways Community Care Limited (Leicestershire County)

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

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. This is the first assessment for this newly registered service. We rated this key question as Inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

This service scored 33 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

We reviewed peoples care records and found some to have conflicting information and lacked guidance for staff teams to follow. Care records were not consistently reviewed in line with the providers policy to ensure they were reflective of peoples assessed and changing needs. Within the records provided, 3 peoples care records had not been reviewed or updated since 2021. This meant staff did not have up to date guidance to ensure people were supported in line with their personal preferences or changes in need.

Some relatives told us they were involved with care planning and decisions about their family member's care; however, other relatives told us they hadn’t seen a care plan and were unsure how often these were reviewed. One relative said, “Day care knows [person] very well, thank God. I’m frustrated with Lifeways as they don’t allow staff to read the care plans”. This presented a risk people who know the person well were not always involved in the development of assessing people’s preferred care and support needs.

We observed staff did not always follow guidance within peoples care records. For example, A persons care records included guidance for staff to follow to support the person with distressed behaviours, however, staff deployment meant these approaches were not always completed by staff. This meant incidents of distress and harm were not managed in line with guidance. This was evidenced through an increase of incidents involving the person injuring themselves and others.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

People who required support with acute health needs did not have their care records updated to reflect best practice guidance from health professionals. A lack of systems and processes to ensure national guidance regarding the safe delivery of health care tasks was not implemented across the service. The provider did not have systems in place to identify people who may require support with health needs. Ineffective oversight to ensure people’s health needs were clinically reviewed meant people with acute health conditions were at risk of harm and deterioration. People who required support with their emotional and behavioural needs did not always have plans in place to ensure staff supported people safely or effectively. Where guidance for staff had been completed, this had not always followed a PBS methodology, and a functional assessment had not been completed by a trained and skilled person to ensure they were effective and responsive to people’s individual needs.This meant approaches adopted by staff teams to support people with active and reactive strategies to manage people in distress, were not purposeful or meaningful to individuals. There was a lack of detail regarding how these strategies were to be delivered in line with individual assessed need, personal preference or what communicative techniques where to be use.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The registered manager told us the management team were transferring information on to a new electronic care planning system. However, staff told us paper care records were regularly taken out of service for periods of time with nothing in place at the residence to ensure current guidance was accessible for staff to follow. One staff member told us, “We email information to the management team all the time, but the records never get updated”.

Staff were not always able to describe peoples assessed needs. During the inspection we found essential care records and documentation including incident forms and mental capacity assessments were missing from peoples care records. This meant people's needs may not be met consistently or safely

Some relatives told us they had positive experiences of their family member moving between services and the registered manager had received compliments from partner organisations for transitions for people. However, when significant concerns were raised with the management team in relation to safeguarding people, external partners told us there was a lack of communication and significant delay in timely responses from the registered manager to ensure organisations could work together effectively. Partners were not assured appropriate and timely actions were taken by the registered manager to review peoples care and keep people safe.

The provider did not support people to manage their health and wellbeing, so people could not maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff did not always follow health professionals' advice to manage health conditions. For example, health professionals had provided guidance for one person which directed staff to support them to move regularly to maintain strength and mobility. During the inspection we observed the person remained seated for several hours with no staff intervention. This meant the person remained at risk of decreasing mobility as they did not receive support to maintain muscle strength.

Staff supported people to make meal choices in line with their known preferences. However, relatives told us they raised concerns about the lack of physical activities and the quality of food offered to their family members. One relative told us, “[Name] food looks disgusting, they had kiev, mashed potato and beans. It was hard and stone cold. I added tomato sauce to mash it up more. None of the people ate it”. Another relative said, “There are no physical activities going on in there. I’ve asked if the staff can walk [Name] up and down the road to stretch their legs. They never do.” Peoples care plans did not demonstrate support or engagement to make healthier choices about their diet or physical activities. This meant staff were not consistent in promoting opportunities for people to improve their lifestyle and wellbeing.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Some relatives told us they were not assured the provider was meeting their family members outcomes and clinical needs. One relative said, “We have tried to step back doing this, but [Name] has poor dental hygiene. The dentist has written to staff to say about how they are not helping them to look after her teeth”.Another relative said, “I don't think they are meeting [Name] other needs, like taking them out in their wheelchair. They would love to have the occasional lunch out. All [Name] does is sit and watch TV”.This demonstrated a lack of systems and process to engage with people and their relatives to achieve effective outcomes for people both socially and clinically. People were not consistently supported to maintain their health and social wellbeing. Lack of management oversight in relation to people’s acute health needs meant people were at risk of deterioration and poor care and treatment.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff were observed offering people choices and supporting them to make decisions. For example, staff had identified through a best interest decision, a person was able to make informed decisions through being offered 2 choices and using an electronic application on their laptop. However, mental capacity assessments were not consistently undertaken or written in line with the Mental Capacity Act. Staff did not consistently demonstrate a good understanding of MCA and how to apply this. Where assessments were in place people and were not regularly reviewed to ensure they remained accurate and effective in ensuring people’s rights were upheld.