Lifeways Community Care Ltd (Leicester)

On this page

• 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 Good. At this inspection the rating has changed to Inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

This service scored 33 (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.

People's needs were not consistently assessed in a comprehensive or person-centred way. Care and support plans did not fully reflect their wishes, preferences or changing needs. Assessments did not always contain sufficient information to identify people's current care and support needs, preferences, and desired outcomes. Some care plans lacked detail and, in some cases, did not reflect changes in people's health, wellbeing, or support requirements, particularly when people’s needs changed.

There was limited evidence to demonstrate people, or those important to them, had been involved in assessing needs and developing care plans. Relatives told us they had not been asked for their views or given opportunities to contribute to decisions about their family member's care. Comments included, “They don’t get in contact for information and they don’t send out information. It is concerning.” And “I don’t hear anything from them at all. I will ring them to see how [person] is but other than that they don’t phone me nor have they asked me for any information about [person].”

This meant care planning processes did not always reflect a holistic understanding of people's needs and could not demonstrate relevant individuals had been involved in accordance with best practice.

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.

People were not always supported in line with evidence-based practice to ensure the safe management of their medicines. 1 person who required support with the preparation and administration of complex medicines did not have the appropriate authorisations, clinical guidance, or documented processes in place to ensure medicines were administered in accordance with prescribers' instructions. This meant staff could not demonstrate they were appropriately authorised, competent or accountable for undertaking aspects of medicines management, creating a risk that medicines may not be administered safely or as prescribed. This practice was not consistent with the requirements including NICE guidance and medicines governance principles.

Additionally, despite ongoing development of risk mitigation plans to support people to eat and drink safely where there was a risk of choking, and to support the safe moving and handling of people to prevent injury, we observed poor staff practice which did not follow people's care plans or risk assessments. This meant people were exposed to avoidable risks, including choking, injury and harm, as staff did not always implement agreed control measures designed to keep people safe. The provider had not ensured staff consistently understood or followed established legislation, best practice or guidance, resulting in a gap between planned care and the care people actually received.

The provider did not always work well across teams and services to support people.

Staff and external professionals did not always work together effectively to ensure people received safe and consistent care. Records showed recommendations and guidance from health and social care professionals were not always acted upon or embedded into practice in a timely way. In some cases, there was a lack of clear evidence to demonstrate staff had followed professional advice or escalated concerns when people's health needs changed.

Managers were not always effective in monitoring whether agreed actions had been completed. This increased the risk of people not receiving care and treatment in line with current professional guidance and meant opportunities to improve people's health outcomes could be missed.

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 support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not consistently supported to maintain and improve their health and wellbeing. Systems to identify, monitor and respond to health risks were ineffective, and staff did not always follow assessed needs or professional guidance to promote positive health outcomes. Care records did not consistently demonstrate people received personalised support to maintain a healthy lifestyle, manage long-term health conditions or access appropriate healthcare interventions when required.

People were not consistently supported to maintain a healthy and balanced diet in accordance with their assessed needs. We reviewed records for 1 person who required staff support with an International Dysphagia Diet Standardisation Initiative (IDDSI) modified diet due to risks associated with swallowing difficulties. Food and fluid charts completed between June 2026 and July 2026 showed the person was routinely offered milk-based foods, including tapioca, custard and rice pudding, for all three meals of the day. During our inspection, we observed the only food available within the person's home consisted of tins of similar milk-based products. Staff told us this was because they knew the person liked these foods.

However, there was no evidence staff had considered the nutritional adequacy of the person's diet or sought professional advice to ensure their nutritional needs were being met. The person's dietary preferences had been prioritised without appropriate consideration of the risks associated with a highly restrictive diet. This placed the person at increased risk of malnutrition, vitamin and mineral deficiencies, weight loss and deterioration in their overall health and wellbeing.

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.

Systems to monitor and improve outcomes were ineffective. Although some people had identified goals and health needs within their support plans, there was limited evidence these were consistently reviewed, monitored, or used to improve outcomes. Where people required staff support to monitor health conditions, such as dysphagia and epilepsy, recording was inconsistent, incomplete and lacked sufficient detail. For example, records relating to seizure activity and food and fluid intake, swallowing difficulties, and associated risks were not always accurately maintained. This meant staff could not be assured they were providing health professionals with reliable and comprehensive information to inform clinical assessments, reviews, and decision-making.

Leaders were unable to demonstrate effective oversight of how health monitoring information was being gathered, analysed, or used to achieve positive outcomes for people. The absence of robust monitoring arrangements meant there was a risk changes in people's health conditions were not identified promptly, escalating patterns may have been missed, and opportunities to seek timely intervention from health services were reduced. This placed people at increased risk of receiving care and support which did not fully meet their needs and meant clinical teams may not have had access to accurate information on which to base treatment plans, risk management strategies, and healthcare decisions. As a result, the provider could not be assured people were consistently receiving the support necessary to maintain their health, safety and wellbeing or achieve the best possible outcomes.

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

While staff demonstrated an understanding of the importance of seeking people's consent before providing care and support, records did not consistently evidence how consent had been obtained or reviewed. Where people lacked capacity to make specific decisions, documentation was not always sufficiently detailed to demonstrate decisions had been made in accordance with the principles of the Mental Capacity Act 2005. In some cases, assessments of capacity and associated best interest decision-making records were incomplete or absent, and it was unclear whether people, their representatives, and relevant professionals had been appropriately involved in decisions about care and treatment. This meant the provider could not always demonstrate people's rights were being fully protected, or care and support were consistently delivered with appropriate lawful consent.