We carried out a review of the data available to us about Lifeways Community Care (Doncaster) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lifeways Community Care (Doncaster), you can give feedback on this service.
Lifeways Community Care provides personal care to people living in their own homes, including supported living schemes. They support people living with a learning disability. At the time of the inspection there were 73 people receiving care and support.
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.
Right Support
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People and their relatives confirmed this. A relative said, “The staff are brilliant with [Relative]. The staff are trying to make them independent. It’s a lot of relief for me as I know they are being well looked after.”
People were supported to maintain and pursue their interests and to achieve their aspirations and goals. The service made reasonable adjustments so people could be fully involved in discussions about how they received support. People received their medicines as prescribed. We identified some minor documentation issues at one scheme, which was rectified by the registered manager immediately.
Right Care
People received care and support from staff who knew them well and understood their needs and considered their preferences. Staff interacted positively with people and had a caring and respectful approach. Staff understood people’s individual ways of communicating. Staff could recognise and report abuse and there were enough appropriately skilled staff to meet people’s needs and keep them safe.
Staff sought appropriate advice from healthcare professionals in a timely way and staff ensured this was followed. Feedback from health care professionals was very positive and confirmed staff met people’s health needs.
Right Culture
The culture of the service was open and empowered individuals to express their views and be in control of their lives with the support of staff. People received support based on inclusion, respect and transparency.
People and their relatives told us they felt confident to approach the management team and that their suggestions would be heard and responded to. A range of quality checks with oversight at provider level helped to maintain and improve the service and the lives of people supported
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 requires improvement (published 18 December 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook this focused inspection to check they had continued to make improvements that were identified from the information we held about the service. This report only covers our findings in relation to the Key Questions, Safe, Effective, Responsive and Well-led. 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 changed from requires improvement to good. 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 (Doncaaster) on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Lifeways Community Care (Doncaster) provides care and support for people living in their own homes. The provider is registered to provide homecare and supported living services to people in the community with a learning disability. This included supported-living schemes, with between one and six people living together in small domestic style houses and bungalows. Supported living schemes were in Doncaster, Sheffield, Barnsley and Grimsby.
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. At the time of our inspection the service was supporting 63 people with their personal care and support needs.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Governance arrangements were not as effective or reliable as they should be. Further improvement was needed in the quality assurance processes to identify shortfalls and to drive improvement. Support plans and risk assessments relating to people's health needs and the environment were completed but needed more person-centred information to help protect the health and welfare of people who used the service.
Systems were in place to make sure people received their medicines, which included staff receiving medicine training and regular audits of the system. People told us they always received their medicines at the appropriate times. However, some staff had not had their competency checked for over a year. When this was pointed out to the registered manager she took immediate action.
The registered provider had a policy and procedure in place for the safe recruitment of staff. However, we found a small number of gaps in the information required to be obtained during the recruitment process. This was dealt with during the inspection. There were appropriate numbers of staff employed to meet people's needs and provide a personalised service.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. Most people's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Some people had the opportunity to choose, plan and take part in a range of activities that met their preferences and needs, others less so. Some relatives thought more social stimulation should be provided for their family members.
People and relatives were confident any concerns and complaints would be recognised and investigated. People were given feedback from complaints, but not always told the outcome of safeguarding investigations. Also information provided to people did not always meet the requirements of the accessible information standard.
The registered manager had a system of quality assurance checks to ensure the home was meeting required standards and people who used the service were well cared for. However, governance arrangements were not as effective or reliable as they should be. Further improvement was needed in the quality assurance processes to ensure the correct information was inputted and any actions needed were clear to see. The service had up to date policies and procedures which reflected current legislation and good practice guidance.
People who used the service, their relatives, staff and healthcare professionals spoke positively about this service. People told us they felt safe and were protected from abuse by staff that were knowledgeable and had the right skills to meet their needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The atmosphere in the homes was supportive and caring. People had formed positive relationships with staff and clearly enjoyed their company. People were supported to maintain their independence and staff maintained people's rights to privacy and dignity.
People were supported to maintain good health. Staff supported people to eat and drink sufficient amounts to maintain their health. Where necessary, staff liaised with health and social care professionals to ensure effective care and support was provided to people.
People's needs were assessed and developed into a support plan. Further work was underway to ensure support plans contained detailed information to enable people to receive appropriate care and support that was responsive to their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
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 3 July 2017).
Why we inspected:
This was a planned inspection based on the previous rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We found evidence that the provider needs to make improvement. Please see the relevant key question sections of the full report. You can see what action we have asked the provider to take at the end of this full report.
Follow up:
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service has a registered manager in place. 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 our last inspection of this service in August 2016 the service was rated as Good.
People told us they felt safe with the staff from Lifeways. Staff knew how to keep people safe and risks to people's safety and well-being were identified and managed. People's care records were regularly reviewed and updated to reflect the change in their needs. There were sufficient numbers of staff deployed to support people. The provider had a robust recruitment process which ensured that potential staff where suitable to work with vulnerable people.
People kept their medicines in their own homes and were prompted and or supported by staff to take them and this was managed and recorded appropriately. People were asked for their permission before staff assisted them with care or support.
Staff received supervision from their manager which helped them to feel supported and valued, although the provider had recognised that annual staff appraisals had not consistently taken place. Staff told us they felt able to seek assistance when they needed to.
Where applicable, people received support to eat and drink regularly and were assisted to access healthcare appointments as needed. People's privacy and dignity was respected and promoted. People told us they were treated with kindness and compassion by staff and continuity of staff positively impacted on the ability to develop meaningful relationships with care staff.
People's care records were regularly updated to provide a detailed account of their needs and care. People told us they felt confident to raise anything that concerned them with staff or management, and any issues were addressed and resolved. Arrangements were in place to obtain feedback from people who used the service; which showed that people where happy with the service they received.
People and staff were positive about both the registered manager and provider. The registered manager and provider regularly audited the quality and safety of service provision. If issues were identified, they took action to address them.
The provider did not always ensure that notifiable incidents were reported to CQC in a timely manner.