Archived: Lifeways Community Care (Taunton)

At the time of this inspection the service supported 31 people living in seven different premises, including single occupancy and shared occupancy properties. The service is registered for the provision of personal care in people’s own homes. This includes support with personal care, such as assistance with bathing, dressing, eating and medicines. We call this type of service a ‘supported living’ service.

People’s accommodation was provided by separate landlords, usually on a rental or lease arrangement. The service was responsible solely for the provision of personal care and not for the provision of the seven premises. People who used the service had a wide range of cognitive impairment and/or other support needs, ranging from mild to severe learning disabilities or autistic spectrum disorders. Some of the people had very complex support needs and required support from the service 24 hours a day. Other people were more independent and received support for just a few hours a day to help with their daily routines.

The provider’s current area manager had applied to the Care Quality Commission (CQC) to become the registered manager for the service. Their application was currently in progress. A registered manager is a person who has registered with the CQC 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.

During this inspection, we found the provider had not always ensured consent or decisions taken on behalf of a person who lacked the metal capacity to do so had been obtained or recorded in line with current Mental Capacity Act 2005 legislation. This placed people at risk of receiving care that was not in line with their preferences. The service had not highlighted to the relevant local authority when people were under continuous supervision and control and were not able to leave their supported living accommodation independently. This meant that people were unlawfully deprived of their liberty. Governance systems used in the service had not identified these shortfalls of effectively monitored the health, safety and well-being of some people.

During a review of records, we found that some risk assessments were not reflective of people’s current risks. Some people receiving a high level of support from the service were not consistently socially or actively supported. People received their medicines as they needed them, however current arrangements for people receiving their ‘As Required’ medicines. People were not always supported by staff they knew. The service had various staff vacancies and current staff levels were not always ensuring staff received a break. Staff knew how to report abuse and recruitment procedures were safe.

We saw that generally people received the support they needed to eat and drink sufficient amounts. However, we found an example where one person had sustained a significant weight loss that had not been identified or escalated placing them at risk.

Staff received an induction aligned to the Care Certificate which was introduced in April 2015 and is an identified set of standards that health and social care workers should adhere to when performing their roles and supporting people. Staff also received ongoing training and support through a supervision and induction process.

We observed that staff interacted and cared for people in a kind and caring way. Staff we spoke with understood the people they supported and could detail their likes and preferences. People had formed close friendships with others in their supported living service and maintained contact with friends and family.

People were involved in care planning and reviews, however we were told by staff that there had been times when they could not access the care plans. This placed people at risk of not receiving personalised care. People met the staff that supported them before using the service. Where required, people had positive behaviour support plans in place and had been involved in their creation where possible. There were systems to ensure complaints could be heard and responded to.

Staff we spoke with commented less positively about the high turnover of senior management within the service, both locally and regionally. There were systems to seek the views of people, their relatives and staff in the form of a survey. Where required, action plans had been created to address shortfalls. There were systems to communicate key messages to staff and the provider had systems to communicate with people and their relatives.

We found three beaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

People were helped to participate in activities of their choice, they said they enjoyed 'art, music, going to the gym and football'. People said that if there were any changes 'staff will tell me'. People said staff treated them 'fairly and with respect'. Two relatives said the staff were 'good; they provide support and are well trained'.

The agency provided support to people with a range of support needs. Some people required support twenty four hours a day while others were becoming more independent and were reducing their hours.

The service aimed to provide people with a small team of carers that knew them well and were trained to understand their individual needs.

The service had comprehensive systems in place to monitor the quality of the service offered. The existing annual quality assessment tool covered all aspects of the essential standards of quality and safety.