Archived: Lifeways Community Care (Wiltshire)

Updated 17 November 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 checked 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 was a comprehensive inspection and took place on 22 and 23 August 2017 and was announced. The inspection was carried out by one inspector.

Before the inspection, we reviewed the information we held about the service. This included notifications about important events which the service is required to send us by law.

We reviewed the 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 improvements they plan to make.

We used a number of different methods to help us understand the experiences of people who use the service. We received feedback from two healthcare professionals who supported the service to meet people’s care needs. During our inspection we visited people in their own homes to look at records and observed the interactions between four people using the service and staff. We spoke with four staff who worked at Lifeways and we spoke with the registered manager.

We looked at documents that related to people’s care and support and the management of the service. We reviewed a range of records which included six care and support plans and daily records, staff training records, staff duty rosters, staff personnel files, policies and procedures and quality monitoring documents.

Updated 17 November 2017

Lifeways Community Care (Wiltshire) is a national organisation which provides care for people with specialist needs living in their own homes. Lifeways Community Care in Melksham has been operating since January 2014 to provide supported living services for people living in a range of housing provision in the local area. They provide personal care to adults over the age of 18.

This inspection took place on 22 and 23 August 2017 and was announced. The provider was given short notice because this gave the provider an opportunity to plan our visit with the people using the service. During the last inspection which concluded 17 April 2015 we rated the service good overall. However we rated the safe domain as requires improvement due to the amount of agency staff which sometimes resulted in a lack of staff consistency. The service demonstrated the amount of agency staff cover had reduced over recent months leading to the inspection.

At this inspection we found the service remained Good. However, how staff have been deployed to people receiving support in one city had been raised to us as a concern. We received feedback from two healthcare professionals prior to this inspection; both described how the inconsistency and on occasions, lack of staff had impacted negatively on people. The provider had recently decided it was not financially viable to continue providing the service, and had given notice to the individuals living in the city who were receiving support from Lifeways.

A registered manager was employed by the service who was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

The registered manager had taken action to improve the number of consistent staff to cover shortfalls. The registered manager said two local agencies are used where additional staff were required and this has helped to ensure consistency for people. All of the staff we spoke with said staffing levels had improved and the use of regular agency had provided consistency. The registered manager explained Lifeways had experienced difficulty recruiting staff, but had introduced incentives to improve staff recruitment.

People and staff described the management structure as being ‘more stable’. The registered manager provided clear leadership and more team leaders were in post to support the management of the service.

The registered manager worked closely with other agencies and promoted an open and transparent culture with a strong emphasis on continually striving to improve the service. There were effective systems in place to monitor the quality and safety of the service provided and the provider had a clear plan on further development of the service.

Staff knew how to report any safeguarding concerns and were aware of the provider's whistle blowing policy. People's care plans contained detailed risk assessments that covered areas such as skin integrity, mobility, nutrition and falls. Where people were at risk, their records outlined management plans on how to keep them safe. People were supported by sufficient staff to keep them safe and the provider ensured safe recruitment practices were followed.

People received their medicines as prescribed and medicines were stored safely and securely.

We saw positive interactions with staff who had built caring and respectful relationships with people they supported.

People had choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and to meet their nutritional needs.

People had opportunities to engage in a choice of activities which were meaningful to them.

People knew how to raise any issues and their concerns were responded to by the registered manager. The registered manager ensured peoples' and relatives' views were sought and appropriate action taken when required.

Further information is in the detailed findings below.