Lifeways Community Care Ltd (Leicester)

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last rated inspection we rated this key question Good. At this inspection the rating has changed to Inadequate . This meant people did not feel well-supported, cared for or treated with dignity and respect.

This service scored 35 (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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

People's experiences of being treated with kindness, compassion and dignity were inconsistent across the service. While at some locations we observed staff interacting with people in a caring, respectful and compassionate manner, promoting their dignity and wellbeing, this was not the experience for everyone. At other locations, we identified practices which fell significantly below expected standards of dignified care. For example, we observed staff using soiled bed sheets to wipe a person’s mouth while supporting them to eat. This practice was undignified, failed to demonstrate respect for the individual, and increased the risk people could feel devalued.

The disparity between the positive experiences observed in some settings and the poor approaches identified in others meant the provider could not be assured people consistently received care which protected and promoted their dignity. These findings demonstrated the provider had not embedded a service-wide culture where people were always treated with the respect, compassion and dignity they had the right to expect.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People were not always supported in a way which consistently reflected their individual needs, preferences, cultural backgrounds and protected characteristics. Care records did not always contain detailed, person-centred information about people's histories, beliefs, identities, communication needs or what mattered most to them. Information relating to people's cultural backgrounds, religious needs and other protected characteristics was not always clearly recorded or reflected in support planning.

For example, 1 person had a SALT plan in place which detailed their preferred and most effective communication methods to support them during periods of distress. This information had also been incorporated into the person’s PBS (Positive Behaviour Support) plan to promote a consistent and person-centred approach. However, during our inspection we observed the person becoming distressed and anxious. Staff did not use the communication methods outlined in the plans. This meant staff were not always equipped with the information and skills required to respond consistently to the person’s needs, which placed them at risk of receiving care and support that was not fully personalised or delivered in line with their assessed preferences.

In addition, changes in people's needs and preferences were not always updated promptly, meaning staff may not have had access to current information to provide personalised support.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Although people received support from staff who knew them well, practice did not consistently promote people's independence, choice and control. During our observations, we saw examples of staff completing tasks for people rather than providing encouragement, prompting and support to enable them to do things for themselves. This meant opportunities to develop and maintain independent living skills were sometimes missed.

Staff understanding of how to support people to exercise independence, choice and control was inconsistent. For example, when we asked a staff member how they supported 1 person to make decisions about how they spent their time, they told us, "[Person] can't make choices or know what they want. They don't talk." This response demonstrated a limited understanding of person-centred support and a strengths-based approach. It reflected an assumption that a person who does not communicate verbally is unable to express preferences, make choices or direct their own support. As a result, there was a risk staff took over tasks and made decisions on people's behalf, rather than supporting them to express their views, develop their skills and maintain control over their daily lives in accordance with the principles of Right Support, Right Care, Right Culture.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Not all people's immediate needs were consistently responded to in a timely way. During the inspection, we observed a person repeatedly shouting for support with their personal care on several occasions. Despite clearly expressing a need for assistance, the person was left waiting for their personal care for up to 1 hour before staff were able to support.Records and feedback from staff demonstrated this was due to commissioned hours and staffing rosters not reflecting people's assessed needs and levels of dependency. This meant the person's dignity, comfort and wellbeing were not consistently maintained, and their immediate care needs remained unmet for a prolonged period. The delay caused the person visible distress and anxiety as they continued to call out for help without intervention.

This demonstrated the provider had not ensured staffing arrangements were effectively planned and deployed to meet people's needs when required. As a result, people were exposed to the risk of avoidable distress, discomfort and potential deterioration in their wellbeing because timely care and support could not always be provided.

The provider did not promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

The provider's arrangements to support workforce wellbeing and enablement required improvement. Staff told us they were committed to supporting people and spoke positively about those they supported. However, a lack of sustainable and effective management meant staff did not always receive the leadership, guidance and support necessary to carry out their roles effectively. Frequent management changes and inconsistent leadership had resulted in staff often working without clear direction, oversight or opportunities for professional reflection. This increased the risk of staff becoming isolated in their roles and making decisions without appropriate managerial support or challenge.

Systems to ensure staff received regular supervision, competency assessments and ongoing professional development were not consistently effective. Staff were often required to support people with complex needs and make important decisions about their care and wellbeing, without appropriate training or experience.

Staff described inconsistencies within the service which negatively impacted morale and team cohesion. Several staff told us there was a disparity between staffing teams, workloads and expectations, particularly between staff supporting people with higher levels of dependency and complexity and those working in services with lower levels of support needs. One staff member said, "It's unfairly managed, some of us have a very busy workload and more responsibility than others." Staff told us these inequalities created friction between teams and contributed to feelings of frustration and being undervalued. Leaders had not effectively recognised or addressed these concerns and could not demonstrate how they were supporting staff wellbeing or creating a consistent and positive culture across the service.