The Care Quality Commission (CQC) has rated Lifeways Community Care (Warwickshire & Coventry) in West Bromwich, West Midlands, inadequate overall, following an inspection in July.
Lifeways Community Care (Warwickshire & Coventry) provides personal care to people with a learning disability or autistic people in their own homes within supported living and domiciliary care settings.
The inspection was prompted, in part, by concerns CQC received about a closed culture, allegations of abuse and neglect, and poor managerial oversight.
Following the inspection, the service’s overall rating has dropped from good to inadequate. It is also rated inadequate for being safe, effective and well led, and rated requires improvement for being responsive and caring.
The service is now in special measures which means it will be kept under review and re-inspected to check if sufficient improvements have been made.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“When we inspected Lifeways Community Care (Warwickshire & Coventry), it was very concerning to see that the quality of care had declined significantly since we last visited.
“It was unacceptable that the service took no action when safeguarding concerns were raised.
“We were made aware of a serious allegation of abuse which hadn’t been investigated and no action had been taken to safeguard the person involved, including notifying the relevant external agencies. The registered manager only took action once we raised our concerns with them.
“Leaders failed to ensure that events which placed people at harm were reported, recorded and actions put in place to prevent the risk of reoccurrence. For example, care records stated that one person had been involved in 42 instances of choking over a prolonged period with no preventative actions taken.
“The provider of the service also failed to ensure proper assessments of people's needs were carried out. We saw that there was no assessment or care plan in place for staff to follow for a person who was prescribed medicines for a serious mental illness. This increased the risk of their health condition being left untreated or worsening, which is totally unacceptable.
“We have told the provider what urgent improvements need to be made to address the concerns identified. We continue to monitor the service to ensure people are safe, and we will return to check on progress.”
Inspectors found the following during this inspection:
- People were not kept safe from avoidable harm because staff did not understand how to protect them from abuse or work well with other agencies
- Some staff lacked understanding of the different forms of abuse and their associated responsibilities
- There was no evidence of any recorded assessment of one person's needs and preferences, meaning they were at risk of receiving inappropriate care
- The provider had failed to ensure there were enough staff on duty to meet people's needs, with its own audit finding staffing levels were 30% below the required level. Agency staff covered the shortfall
- The service used a tool designed to identify the correct number of staff required. Inspectors looked at this tool and found it to be incorrectly used and therefore ineffective
- Although audits of medicines were carried out, these were undertaken by care staff and not the service manager. This increased the risk of errors due to an untrained or inexperienced member of staff completing the audits
- When people's needs and choices changed, the provider failed to review assessments. For example, one person's healthcare needs were known to have changed, but the provider had failed to reassess them.