23 May 2018
During a routine inspection
Not everyone using Lifeways Community Care (South London) receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service did not have a registered manager in post, the previous registered manager left in July 2017. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At this inspection we found that improvement was required because some staff described a poor working culture at the service. They told us they did not feel supported by senior managers, were unable to question practice and did not feel they could work in an open and transparent manner. The provider worked in partnership with key organisations such as the local authority but did not consistently update them when changes in management staff occurred which resulted in important information not being always communicated.
The provider had safeguarding adults’ policies and procedures in place and staff understood their responsibility to safeguard the people they supported from abuse. Staff were also aware of the provider's whistleblowing policy and procedure. People’s finances were managed safely. Risk to people had been assessed and there were appropriate management plans in place to mitigate any identified risks. There were procedures in place to deal with foreseeable emergencies and people had personal emergency evacuation plans in place.
Appropriate recruitment checks took place before staff began working at the service and there were enough staff available to support people's needs. People received adequate support to take their medicines safely. People were protected from the risk of infectious diseases because staff had completed infection control and food hygiene training, and knew of action to take to reduce the spread of infections. Where issues were identified, lessons were learnt to improve the quality of the service.
Before people started using the service they were assessed to ensure their needs would be met. New staff were supported with an induction to familiarise themselves with the provider’s policies and procedures and to shadow experience staff. All staff were provided with mandatory training to ensure they had the knowledge and skills to undertake their roles. Staff were supported through supervision and appraisals to support them to perform their jobs efficiently.
People were supported to maintain good health and had access to a GP and other healthcare services when required. They were supported to cook and eat nutritious food in sufficient amounts for their health and wellbeing. The provider worked in partnership with other health and social care services to provide people with joined-up care. Staff were aware of the importance of seeking consent from people and demonstrated an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People told us that staff were kind and compassionate towards them. People and their relatives had been consulted about their care and their views were taken into consideration when planning their support needs. People’s privacy and dignity were respected, and their independence promoted to maintain life skills.
People received care and support that met their individual needs and preferences. Each person had a support plan in place which provided staff with guidance on how their needs should be met. Staff understood that people's diversity was important and respected their differences and choices. People were supported to partake in various activities of their choice. They were encouraged to maintain relationships with their family and friends. People’s communication needs had been identified and appropriate guidance was in place to ensure their needs were met. The provider had a complaints policy in place and people told us they knew how to complain. Where required, people’s end of life wishes had been discussed with them and appropriate plans were in place to ensure their wishes would be met.
The provider had systems in place to assess and monitor the quality of the service. There were systems in place to continuously learn and improve on the service delivery. The views of people and their relatives were sought through annual satisfaction surveys and regular tenants’ meetings, and this feedback was used to improve the service delivery. The provider understood the requirements of the Health and Social Care Act 2008 and notified the Care Quality Commission (CQC) accordingly.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.