Lifeways Community Care (South Shields), provides residential care for up to four people. At the time of inspection, three people were using the service. People's experience of using this service and what we found
People had not always received person-centred care or received the emotional support as outlined in their care plans. Staff told us the service was very regimented and at times institutional. People had not always been allowed to choose their own range of activities.
Systems in place had not been effective in protecting people from abuse. Staff told us they were aware of the whistleblowing policy and had identified and raised concerns with both the registered manager and the senior service manager. These concerns were regarding poor practice and management culture within the service, but nothing ever changed.
Management of the service had not successfully identified the issues we found during the inspection. This included inappropriate actions which had been recorded in one person’s care plans not being fully investigated. Outstanding actions in relation to premises safety checks had not been followed up or completed. People’s hospital passports did not always contain up-to-date information to allow people to receive safe and consistent care if they were admitted to hospital.
The majority of staff told us they did not feel supported, listened to, or valued by their registered manager and senior service manager, and they often felt stressed and demotivated. Staff had attended regular team meetings and supervision sessions with the registered manager/team leader. However, the majority of staff told us they had not found these meetings to be of any benefit.
Management had failed to follow the provider’s own organisational process, regarding the investigation of internal concerns and one external investigation.
Staff had received training to support them in their role. Staff, relatives and a visiting professional told us people received safe care.
Robust infection control procedures were in place for people, staff and visiting professionals to the service.
People’s communication needs were assessed and recorded in their care plan. During the inspection staff were seen to engage with each person in their unique way and people responded very well.
The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, lack of choice and control, limited inclusion e.g. people did not have choice in their range of activities.
The senior service manager present during inspection, was very open and honest with the inspector during and after the inspection process. They listened to all feedback provided, and they and the provider, took immediate action to address the concerns which had been raised.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published June 2018).
Why we inspected
We received concerns in relation to the management of the service and a potential closed culture environment. As a result, we undertook a focused inspection to review the key questions of safe, caring, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key question. We therefore did not inspect this. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection. Please see the safe, caring, responsive and well-led sections of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in regulations 9, 10, 12, 13 and 17 at this inspection.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.