Archived: Lifeways Community Care (South London)

Updated 4 October 2018

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 inspection took place on 23 May, 31 May and 1 June 2018 and was announced. We gave the service 5 days’ notice of the inspection site visits to enable them gain consent from people for an inspector to visit them in their homes. Inspection site visit activity started on 23 May 2018 and ended on 5 June 2018. On the first day of our inspection, we visited the office location to see the manager and office staff; and to review care records, staff files and other records used in managing the service such as policies and procedures. On 29 May 2018 an expert by experience made calls to people on the telephone whilst they were in their homes. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

On 31 May 2018, one inspector visited one supported living scheme and on 1 June 2018 another inspector visited two supported living schemes. During these home visits, we spoke with people to gather their views about the service and observed how they were being cared for. We also spoke with staff and looked at care plans and other records used in managing the service.

Prior to the inspection we reviewed information we held about the service including notifications we had received. Notifications are information about important events the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information in the planning of the inspection.

We spoke with six people and three relatives. We also spoke with 18 staff including the area manager, a regional quality manager, office staff and care workers. We reviewed eight care files including care plans and risk assessments. We looked at 10 staff files which included recruitment checks, supervisions and appraisals. We also looked at other records used in managing the service including policies and procedures, accidents and incidents, audits and complaints logs.

Following our inspection, we contacted seven local authorities that commission services from the provider and health and social care professionals to obtain their views about the service.

Updated 4 October 2018

This announced inspection took place on 23 and 31 May and 1 June 2018. Lifeways Community Care (South London) provides care and support to people living in their own flats or houses in various supported living settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. At the time of this inspection 60 people were using the service, many of whom had complex health and communication needs. The service was being provided across six London boroughs and Kent.

Not everyone using Lifeways Community Care (South London) receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service did not have a registered manager in post, the previous registered manager left in July 2017. 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.

At this inspection we found that improvement was required because some staff described a poor working culture at the service. They told us they did not feel supported by senior managers, were unable to question practice and did not feel they could work in an open and transparent manner. The provider worked in partnership with key organisations such as the local authority but did not consistently update them when changes in management staff occurred which resulted in important information not being always communicated.

The provider had safeguarding adults’ policies and procedures in place and staff understood their responsibility to safeguard the people they supported from abuse. Staff were also aware of the provider's whistleblowing policy and procedure. People’s finances were managed safely. Risk to people had been assessed and there were appropriate management plans in place to mitigate any identified risks. There were procedures in place to deal with foreseeable emergencies and people had personal emergency evacuation plans in place.

Appropriate recruitment checks took place before staff began working at the service and there were enough staff available to support people's needs. People received adequate support to take their medicines safely. People were protected from the risk of infectious diseases because staff had completed infection control and food hygiene training, and knew of action to take to reduce the spread of infections. Where issues were identified, lessons were learnt to improve the quality of the service.

Before people started using the service they were assessed to ensure their needs would be met. New staff were supported with an induction to familiarise themselves with the provider’s policies and procedures and to shadow experience staff. All staff were provided with mandatory training to ensure they had the knowledge and skills to undertake their roles. Staff were supported through supervision and appraisals to support them to perform their jobs efficiently.

People were supported to maintain good health and had access to a GP and other healthcare services when required. They were supported to cook and eat nutritious food in sufficient amounts for their health and wellbeing. The provider worked in partnership with other health and social care services to provide people with joined-up care. Staff were aware of the importance of seeking consent from people and demonstrated an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us that staff were kind and compassionate towards them. People and their relatives had been consulted about their care and their views were taken into consideration when planning their support needs. People’s privacy and dignity were respected, and their independence promoted to maintain life skills.

People received care and support that met their individual needs and preferences. Each person had a support plan in place which provided staff with guidance on how their needs should be met. Staff understood that people's diversity was important and respected their differences and choices. People were supported to partake in various activities of their choice. They were encouraged to maintain relationships with their family and friends. People’s communication needs had been identified and appropriate guidance was in place to ensure their needs were met. The provider had a complaints policy in place and people told us they knew how to complain. Where required, people’s end of life wishes had been discussed with them and appropriate plans were in place to ensure their wishes would be met.

The provider had systems in place to assess and monitor the quality of the service. There were systems in place to continuously learn and improve on the service delivery. The views of people and their relatives were sought through annual satisfaction surveys and regular tenants’ meetings, and this feedback was used to improve the service delivery. The provider understood the requirements of the Health and Social Care Act 2008 and notified the Care Quality Commission (CQC) accordingly.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.