Lifeways Community Care Ltd (Leicester)

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the provider met people’s needs.At our last rated inspection we rated this key question Good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People did not always receive care and support which was consistently person-centred and in line with the principles of Right Support, Right Care, Right Culture. Care plans contained limited information about people's strengths, goals, preferences and the outcomes they wanted to achieve. Records were not always updated to reflect changes in people's needs, meaning staff did not consistently have access to accurate and personalised information to guide their practice.

The provider did not always ensure people were placed at the centre of decisions about their care and support. There was limited evidence people were routinely involved in planning how their support should be delivered or in determining how changes in their needs should be responded to. Similarly, relatives and those important to people were not always involved in care planning and reviews where appropriate. This meant the provider could not demonstrate care and support arrangements were developed through effective partnership working or reflected people's views, wishes and desired outcomes.

Observations of practice further demonstrated a lack of consistent person-centred support. Staff sometimes focused on completing tasks for people rather than working alongside them to maximise their involvement, independence, choice and control. As a result, people were at risk of receiving support. that did not fully reflect their individual needs, preferences and abilities, limiting opportunities to promote independence and achieve positive outcomes.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People did not always experience well-coordinated care which ensured their needs were consistently met. Care records were not always accurate, up to date or reflective of people's current needs, which increased the risk of inconsistent support being provided. Information was not always effectively shared between staff teams, and changes in people's needs were not consistently documented or translated into care planning and delivery.

Care was not always integrated with input from other health and social care professionals. We found examples where recommendations from healthcare professionals had not been consistently followed by staff. This meant people were at risk of receiving care which did not reflect current professional guidance or best practice.

The provider could not demonstrate people's care and support were regularly reviewed with them, their relatives and relevant professionals to ensure support remained responsive to their changing needs and personal goals. As a result, people were at risk of experiencing fragmented care and poorer outcomes.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People had communication plans in place which were intended to guide staff in supporting their individual communication needs and preferences. However, these were not always implemented in practice. We found 1 person had been assessed as requiring a 'now and next' communication system, a visual aid using pictures, symbols or words to explain what was happening now and what would happen next, to support their understanding, reduce anxiety and enable them to make informed choices. Despite this assessed need, the communication aid was not available or being used by staff.

During our inspection, we observed the person becoming anxious about an upcoming activity and repeatedly asking questions about going out. Staff attempted to provide reassurance verbally but did not use the assessed communication tools or strategies identified within the person's support plan to help them understand and process information. As a result, the person's distress escalated.. This demonstrated a failure to provide information in an accessible format and meant the provider could not be assured people were consistently receiving information in ways they could understand.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result.

The provider did not have effective systems in place to ensure people, and those important to them, were routinely listened to and involved in decisions about their care and support. This was particularly concerning for people who relied on staff to anticipate their needs, communicate on their behalf, or required relatives and representatives to advocate for them. We found limited evidence these people had been offered meaningful opportunities to share their experiences, express their views, or raise concerns about the support they received. As a result, the provider could not be assured the voices of some of the most vulnerable people using the service were being heard and acted upon.

Relatives consistently described poor communication with the service and told us opportunities to engage with leaders and discuss concerns were frequently missed. Relatives said they were not always kept informed about significant events, changes in care, or issues affecting their family members. One relative told us, “I try and keep communication open but it's hard when you get nothing back.”

Despite the provider having mechanisms in place intended to gather feedback and promote involvement, leaders lacked effective oversight of engagement with people and their representatives and were unable to demonstrate how feedback was sought, analysed or used to improve the service. This meant concerns could go unidentified, opportunities to improve people's experiences were missed, and there was an increased risk people received care and support which did not fully reflect their wishes, needs and preferences.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People did not always experience equitable access to care, support and services. Whilst staff were committed to supporting people, systems were not sufficiently robust to ensure people consistently received timely access to healthcare, specialist input and wider opportunities based on their individual needs. Records showed referrals, follow-up actions and recommendations from external professionals were not always consistently monitored or progressed, increasing the risk of delays in people receiving the support they required.

We found examples where staff had failed to support people to open and review correspondence relating to their health and welfare. As a result, some important information, including healthcare appointment letters, had not been acted upon, leading to missed appointments and delays in accessing appropriate healthcare support. The provider could not always demonstrate barriers to access support had been identified and addressed proactively, particularly for people who required support to understand, manage or respond to written communications.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

People did not experience equitable outcomes across the service, resulting in significant variation in the quality and safety of care they received. We found a clear disparity between locations operated by the provider. At some locations, people received care which was safe, responsive and met their assessed needs, with staff available to provide timely support and promote positive outcomes. However, at other locations, people's experiences were significantly poorer. People experienced delays in receiving support, inconsistent oversight of their care, and reduced opportunities to have their needs met in a person-centred way.

These differences could not be explained by the needs of the people using the service and reflected inconsistent leadership, oversight and deployment of resources across locations. As a result, people were not afforded the same standard of care, support and protection regardless of where they lived. This created inequitable experiences and outcomes, exposing some people to avoidable distress, poorer wellbeing and an increased risk of harm. The provider had failed to ensure a consistent approach to delivering high-quality care across all locations, resulting in unfair and unequal outcomes for people.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider's approach to planning for people's future needs and aspirations required improvement. Whilst some people's support plans contained information about their current care needs, there was limited evidence of proactive planning to support longer-term goals, changing circumstances, increasing independence, or future transitions. Records did not consistently demonstrate how people, those important to them, or relevant professionals had been involved in discussions about future wishes and outcomes.

The provider was not always able to demonstrate support was planned in a way which anticipated changes in people's health, wellbeing, living arrangements or support requirements. Opportunities to develop people's skills, promote greater independence and prepare them for future life goals were not consistently identified or acted upon. This meant people were at risk of receiving support which focused on their immediate needs rather than enabling them to achieve their longer-term aspirations and live fulfilling lives in line with the principles of Right Support, Right Care, Right Culture.