Archived: Lifeways Community Care (Taunton)

Updated 5 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out by three adult social care inspectors. When the service was last inspected during February 2015 no breaches of the legal requirements were identified. This inspection was carried out following concerns being raised with us.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.

We reviewed the information in the PIR and information that we had about the service including statutory notifications. Notifications are information about specific important events the service is legally required to send to us.

During the inspection we spoke with seven people and 10 members of staff. This included the area manager, service managers and support staff. We visited people living in three of the properties that accommodated people supported by the service.

We looked at records relating to the management of the service such as the staffing rota, policies, incident and accident records, recruitment and training records, meeting minutes and governance systems. We also reviewed six people’s care and support records.

Updated 5 August 2017

This inspection took place on 20 and 21 June 2017 and was announced. We gave the service one day’s notice we would be attending as we needed to ensure that senior personnel would be available during the inspection. When the service was last inspected in September 2015, no breaches of the legal requirements were identified.

At the time of this inspection the service supported 31 people living in seven different premises, including single occupancy and shared occupancy properties. The service is registered for the provision of personal care in people’s own homes. This includes support with personal care, such as assistance with bathing, dressing, eating and medicines. We call this type of service a ‘supported living’ service.

People’s accommodation was provided by separate landlords, usually on a rental or lease arrangement. The service was responsible solely for the provision of personal care and not for the provision of the seven premises. People who used the service had a wide range of cognitive impairment and/or other support needs, ranging from mild to severe learning disabilities or autistic spectrum disorders. Some of the people had very complex support needs and required support from the service 24 hours a day. Other people were more independent and received support for just a few hours a day to help with their daily routines.

The provider’s current area manager had applied to the Care Quality Commission (CQC) to become the registered manager for the service. Their application was currently in progress. A registered manager is a person who has registered with the CQC 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.

During this inspection, we found the provider had not always ensured consent or decisions taken on behalf of a person who lacked the metal capacity to do so had been obtained or recorded in line with current Mental Capacity Act 2005 legislation. This placed people at risk of receiving care that was not in line with their preferences. The service had not highlighted to the relevant local authority when people were under continuous supervision and control and were not able to leave their supported living accommodation independently. This meant that people were unlawfully deprived of their liberty. Governance systems used in the service had not identified these shortfalls of effectively monitored the health, safety and well-being of some people.

During a review of records, we found that some risk assessments were not reflective of people’s current risks. Some people receiving a high level of support from the service were not consistently socially or actively supported. People received their medicines as they needed them, however current arrangements for people receiving their ‘As Required’ medicines. People were not always supported by staff they knew. The service had various staff vacancies and current staff levels were not always ensuring staff received a break. Staff knew how to report abuse and recruitment procedures were safe.

We saw that generally people received the support they needed to eat and drink sufficient amounts. However, we found an example where one person had sustained a significant weight loss that had not been identified or escalated placing them at risk.

Staff received an induction aligned to the Care Certificate which was introduced in April 2015 and is an identified set of standards that health and social care workers should adhere to when performing their roles and supporting people. Staff also received ongoing training and support through a supervision and induction process.

We observed that staff interacted and cared for people in a kind and caring way. Staff we spoke with understood the people they supported and could detail their likes and preferences. People had formed close friendships with others in their supported living service and maintained contact with friends and family.

People were involved in care planning and reviews, however we were told by staff that there had been times when they could not access the care plans. This placed people at risk of not receiving personalised care. People met the staff that supported them before using the service. Where required, people had positive behaviour support plans in place and had been involved in their creation where possible. There were systems to ensure complaints could be heard and responded to.

Staff we spoke with commented less positively about the high turnover of senior management within the service, both locally and regionally. There were systems to seek the views of people, their relatives and staff in the form of a survey. Where required, action plans had been created to address shortfalls. There were systems to communicate key messages to staff and the provider had systems to communicate with people and their relatives.

We found three beaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.