Lifeways Community Care Limited (Leicestershire County)

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• 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. At our last rated inspection, we rated this key question Inadequate. At this inspection the rating has remained inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

This service scored 29 (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.

Assessments of people’s needs were not robust, comprehensive or kept up to date, and this placed people at significant risk of receiving unsafe or inappropriate care. Initial and ongoing assessments lacked essential detail and did not fully consider people’s physical health, mental health, communication needs or the complexity of their conditions. For example, a person’s diabetes had recently deteriorated, and they required increased monitoring and additional medicines to support them to manage their blood sugars. Despite this, the person’s care plan and risk‑mitigation strategies had not been updated to ensure staff had the information they needed to recognise deterioration, respond promptly or provide safe support. This meant staff were working without clear guidance, and the person was exposed to avoidable harm.

More broadly, assessments did not consistently draw on information from families or professionals, and they failed to identify the level of support required to keep people safe. As a result, staff did not have an accurate understanding of people’s needs, and care was delivered on incomplete, outdated or incorrect information.

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.

Care and treatment were not delivered in line with evidence‑based guidance or recognised best practice, and this placed people at significant risk of harm. Staff did not consistently use clinical guidance, professional standards or monitoring tools to inform safe decision‑making. We found ineffective monitoring of key health conditions, including seizure record charts, food and fluid charts and records to support distressed behaviour. These were incomplete, inaccurate or not completed at all. This meant staff did not have reliable information to identify patterns, recognise deterioration or escalate concerns appropriately.

People with complex or long‑term health needs were particularly affected, as staff were not following established clinical pathways or evidence‑based monitoring requirements. This meant emerging risks were missed and interventions were not informed by up‑to‑date or accurate information. As a result, people did not receive care or treatment aligned with best practice, and they were exposed to avoidable and ongoing harm.

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

Staff teams and services did not work together effectively, resulting in fragmented, unsafe and poorly coordinated care. Communication between staff, managers and external professionals was inconsistent, and essential information was not reliably shared.

Where health professionals requested monitoring of health conditions, including seizure activity, swallowing and dietary intake, the records completed by staff were poorly maintained, missed significant information and lacked the detail required to support safe clinical decision‑making. This meant professionals responsible for reviewing people’s health did not have accurate or complete information, increasing the risk of deterioration going unnoticed.

Additionally, we found a significant gap in communication between service managers responsible for updating care plans and the staff working directly with people. As a result, important changes to people’s care plans and risk‑mitigation strategies were not communicated to frontline staff, meaning they continued to work with outdated or incorrect information. These failings meant people did not benefit from coordinated, joined‑up care and were exposed to avoidable harm due to ineffective teamwork and poor information‑sharing.

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.

People were not always supported to live healthier lives, and the service failed to promote wellbeing or prevent avoidable deterioration in people’s health. Staff did not have a clear understanding of people’s health conditions, and there was no structured approach to helping people manage long‑term or complex needs.

Opportunities to encourage healthy lifestyles, such as supporting people to attend health appointments, follow clinical advice, or engage in meaningful activity, were missed for a number of people, who required staff to anticipate their needs. Monitoring of key health indicators was inconsistent and often inaccurate, meaning emerging concerns were not identified or acted upon. Staff did not routinely work with external professionals to ensure people received the guidance and interventions they needed. As a result, people were not empowered to make informed choices about their health, and the lack of proactive support placed them at increased risk of avoidable harm and poorer health outcomes.

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.

The service did not ensure effective use of governance systems to monitor people’s outcomes or use information to drive improvements in care. Records intended to track people’s progress, health status and day‑to‑day wellbeing were inconsistent, incomplete or not completed at all.

Staff did not analyse trends or patterns in people’s needs, and there was no evidence monitoring information was used to review or adapt care plans. Key tools such as seizure charts, food and fluid records and supporting distressed behaviours documentation were poorly maintained, meaning emerging risks or changes in people’s presentation were not identified or acted upon.

Leaders did not have oversight of whether people were achieving positive outcomes, and there was no structured approach to evaluating the effectiveness of support. This failure did not support the principles of Right Support, Right Care, Right Culture, as people were not consistently enabled to achieve good outcomes, were not protected from harm, and did not receive care that promoted their rights, independence or quality of life. As a result, opportunities to prevent deterioration or improve people’s wellbeing were repeatedly missed.

The provider did not always tell people about their rights around consent or respect these when delivering care and treatment.

The service did not consistently ensure people gave valid consent to their care and treatment, and improvements were needed to ensure full compliance with the Mental Capacity Act (MCA).

Staff did not always complete capacity assessments when there were indications a person may not be able to make specific decisions about their care. Where people were unable to consent, records did not always show best‑interest decisions had been made in line with the MCA or relevant professionals and family members had been involved.

We also found examples where restrictive practices, including covert administration of medicines, were in place without the required legal documentation or clear rationale. Although some staff had an understanding of the principles of the MCA, this was not applied consistently in practice. These shortfalls meant there was a risk people’s rights, autonomy and ability to make informed decisions were not always fully upheld.