Lifeways Community Care (Halifax)

Updated 17 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by five inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 27 ‘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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

We announced visits to the ‘supported living’ settings because we needed to make sure people consented to a home visit from an inspector. We also gave a short period of notice for the office visit because we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 12 January 2023 and ended on 2 February 2023. On 12 January 2023, 4 inspectors visited 7 ‘supported living’ settings. On 13 January 2023 an Expert by Experience spoke to family members of people who used the service via telephone. Between 13 and 16 January 2023 an inspector spoke with staff members. On 17 January 2023, 1 inspector visited the registered office, and we provided feedback to the provider on 2 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities, clinical commissioning groups and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service, 11 family members and 21 staff, including the regional director, registered manager, area manager, service managers and care staff. We reviewed a range of records, this included 9 people’s care records and medication records. We looked at 3 staff recruitment files and a variety of records relating to the management of the service, including audits and policies.

After the inspection

We requested further information to be sent remotely relating to staff training, monitoring of commissioned hours, risk assessments staff rotas. These were received and reviewed as part of the inspection process. We shared the main findings of this inspection with local authorities who were commissioning care and support.

Updated 17 May 2023

About the service

Lifeways Community Care (Halifax) is a supported living service providing personal care to people living in West and North Yorkshire. The service provides support to people with mental health needs, people with a learning disability and autistic people. At the time of our inspection there were 127 people using the service across 27 ‘supported living’ settings.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service could not show how they met some principles of right support, right care, right culture.

Right Support:

People were not always safe and were at risk of avoidable harm.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Accidents and incidents were not always reported. Where they were, outcomes were not always shared with staff and completion of relevant documentation was missed.

People lived in accommodation that was designed to fit into the local residential area.

Right Care:

People’s needs were not always met.

Care delivery was not always person centred and the service did not always focus on people’s quality of life.

Care, activities and goals were not always planned in a way which met peoples individual needs.

Risks to people were not always assessed or managed safely. Some people did not have the required risk assessments in place for staff to follow, and some people’s risk assessments were not being followed by staff.

Medicines were not managed safely.

People told us they were happy with the staff who supported them. We observed kind and caring interactions between staff and people, and staff knew people well.

People’s communication needs were met and well documented in the support records. Information was accessible for people in a range of formats to ensure their understanding.

People were protected from abuse. The provider had implemented new systems for safeguarding people’s finances, and arrangements were in place to continue to improve this system.

Right Culture:

There were widespread and significant shortfalls in service leadership. Leaders did not assure the delivery of high-quality care.

Governance systems were not effective and did not ensure people were kept safe and received high quality care and support in line with their personal needs.

The service did not ensure staff had sufficient time to give people the care they needed.

Training was not well managed and high numbers of staff were not compliant in some of the required and mandatory training, with some required training not being provided to staff by the provider.

People, relatives and staff told us the service was not good at communicating when concerns had been raised or when things had gone wrong.

Recruitment processes were safe and robust. They ensured staff were suitable to work with the people who used the service.

The management team were responsive to the inspection findings. Action had already been taken to improve systems and processes as outlined in the action plan from the last inspection, this was ongoing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 28 September 2022), and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an announced inspection of this service on 3 and 10 August 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, medicine management, person centred care, governance and staffing.

We undertook this focused inspection in part to check they had followed their action plan and to confirm they now met legal requirements, as well as being prompted due to concerns received about medicines, safeguarding people from abuse, staffing and management arrangements. This report only covers our findings in relation to the key questions safe, responsive and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lifeways Community Care (Halifax) on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred care, safe care and treatment, medicine management, staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

At the last inspection we reported the provider had failed to notify CQC about some significant events and this was being dealt with outside of the inspection process. We reviewed our information and decided no further regulatory action was required. The provider assured us they had improve their systems for notifying CQC and our records supported this.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service remains 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 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame 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.