Lifeways Paragon Limited

Updated 24 April 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 11 & 15 January 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in to assist us. We also wanted to give advance notice to the service given the size of the inspection team and so we could make arrangements and coordinate the inspection team effectively.

The inspection was completed by six Adult Social Care Inspectors and three Experts by Experience and a Pharmacy Specialist Advisor. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service. All three Experts’ by Experience were carers of family members with learning disabilities or who had mental health needs.

We visited eight supported living schemes of various sizes and geographical locations across Manchester, East Lancashire and South Ribble. We made telephone calls to people and relatives at schemes we did not visit. In total we spoke with 26 people and 14 relatives. Where people were unable to speak with us we carried out observations within the support living schemes we visited.

We also spoke with 14 staff, including the two registered managers, six service managers, the organisations learning administrator manager and care staff.

Prior to the inspection the lead inspector gathered the available information from Care Quality Commission (CQC) systems to help plan the inspection. This included the detail of any notifications received, any safeguarding alerts made to the Local Authority, any complaints or whistle-blowing information received. We used a planning tool to collate all this evidence and information prior to visiting the service.

We reviewed 16 care records of people who used the service and associated documentation, such as risk assessments and pre assessments. We reviewed six staff personnel files, training records and records relating to the management of the service, including quality audits and monitoring information.

Updated 24 April 2018

This announced inspection took place on the 20, 21, 22 and 23 February 2018.

Our last inspection of the service was carried out on 10, 11, 15 & 16 December 2014. At that inspection we rated the service as ‘Good’ overall. We rated the ‘effective’ domain as ‘Outstanding’ with the remaining four domains as ‘Good’. At this inspection in February 2018 we found the service remained ‘Good’ overall and ‘Outstanding’ for the ‘Effective’ domain. As the last inspection was rated Good, at this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This service provides care and support to people living in ‘supported living’ settings, so they can live in their own home 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. The agency office is located near the centre of Chorley and is readily accessible for people who use the service and staff, if they wish to visit. The service provides personal care and domestic support to people who live in ‘supported living’ houses over a wide radius. At the time of our inspection care and support was being provided within 44 services across Lancashire, Blackburn with Darwen, Wigan and Greater Manchester. The service was supporting 203 individuals and delivering 10,621 hours of support per week. Lifeways Paragon Limited (Lifeways) was employing 339 Support Workers and Team Leaders to provide this care and support.

Due to the size of the service Lifeways registered two managers with the Care Quality Commission (CQC) who each covered a given geographical area. 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. We spoke with both registered managers throughout the inspection process, who were cooperative throughout.

The service had systems in place to record safeguarding concerns, accidents and incidents and necessary action was taken, as required. Staff had received safeguarding training and they understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and support needs.

People received their medicines as prescribed and when needed and appropriate records had been completed. People spoken with did not raise any concerns about the management of their medicines.

Staffing levels were seen to be sufficient to meet the assessed needs of people. The majority of people and relatives told us that staff were consistent.

People had been 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 supported this practice.

Staff we spoke with had a good understanding of protecting and respecting people’s human rights. Staff spoke positively about confidentiality, privacy and dignity and this came through when speaking with people.

The service had information with regards to support from an external advocate should this be required by those who used the service.

Care plans contained a good level of person centred information with good guidance for staff. People who wished to be involved in care reviews were included in this process and were at the centre of it.

End of life care plans were in place for people and this was approached in a sensitive manner in a way that people could understand.

A number of audits were undertaken to ensure the on-going quality of the service was monitored appropriately and lessons were learned from issues that occurred. A robust management structure was in place that had oversight at a number of levels in accordance with the size of the agency and wider organisation.

The service communicated well with people, relatives and staff. We saw evidence of a number of ways this was done, including memo’s, newsletters and spot-checks.

The feedback from people and relatives was very positive and we received lots of complimentary comments from them about the agency, its staff and the management team.