Lifeways Community Care (Swindon)

Updated 24 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two inspectors, a medicines inspector and an Expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 17 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. The service was run by a manager who was going to register with the Care Quality Commission (CQC)

Notice of inspection

We gave the service a 48 hours notice of the inspection. As the service is small and people receiving care are often out, we needed to make sure we could contact people in person to speak with them.

Inspection activity started on 12 July 2022 and ended on 12 July 2022. We visited the location’s office on 12 July 2022.

What we did before the inspection

Before our inspection, we reviewed information we held about the service. This included information received from the local authority and professionals who work with the service. We looked at statutory notifications. A statutory notification is information about important events, which the provider is required to send us by law, such as allegations of abuse and serious injuries. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 23 June 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with four people using the service and eight relatives of people about their experience of the care provided. We spoke with five members of staff and the manager of the service. We reviewed a range of records, which included 10 people's care records and various medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 24 August 2022

About the service

Lifeways Community Care (Swindon) is part of a national organisation which provides care to people with learning disabilities living in different communities. The Swindon office manages supported living services for people living in the area of Swindon and Gloucestershire. At the time of the inspection the service was supporting 45 people in 17 different locations. People supported by Lifeways Community Care (Swindon) have physical and learning disabilities, profound difficulties in communicating and can, at times, express emotional distress.

People’s experience of using this service and what we found

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Based on our review of key questions Safe, Responsive and Well-led

Right support: Although the care plans and risk assessments were reviewed, they did not always effectively identify all shortfalls noted during this inspection. Not all risks had been considered in relation to people's specific health needs. The service did not always follow best practice with regard to controlled medicines patches. The manager took immediate action to put things right and make improvements. The service supported people to have as much choice, control and independence as possible. The service supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right care: The service did not always ensure that care plans were up-to-date and that risks faced by people had been identified, assessed and planned for. Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had received training on how to recognise and report abuse and they knew how to apply it. People using their individual ways of communicating could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

Right culture: People received good quality care, support and treatment because suitably trained staff were able to meet their needs and wishes. People's support plans were not always up to date, reflect their needs or demonstrate that the person's care had been reviewed. Checks to ensure that records were up-to-date were not always effective. The provider demonstrated a commitment to create a culture of improvement that provided good quality care to people. However, the success of this approach had been affected by changes in leadership at the service and the high use of agency staff. Staff placed people's wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People and those important to them, including advocates, were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 23 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breach in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.