Lifeways Community Care (Warwickshire & Coventry)

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People’s individual wishes and goals were now focused on by staff. There had been changes to the staff supporting people, but new staff were supported to find out what mattered to the people they cared for. People were now achieving better outcomes and enjoying life more. People’s wishes at the end of their lives had started to be considered by staff, with relatives consulted as part of the process. Staff knew how people preferred to be communicated with and supported them appropriately. However, we found an instance where one person’s communication preferences had changed, but this had not been reflected in their care plan. Senior staff agreed to update the person’s care plans in response to our feedback. Systems to manage concerns and complaints and to communicate information to other health professionals were in place, but required further embedding.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider now made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. People or their relatives were now more involved in deciding what care people wanted. One relative said, “They [staff] keep up with the paperwork now, it’s all up to date, things are much better now.” Another relative explained they were encouraged to make any suggestions about their family member’s care. Relatives said this helped to ensure their family member’s care was now reflective of their family member’s wishes, such as more enjoyable things for them to do. One relative said, “Activities are improving now. [Person’s name] loves baking.” A further relative told us their family member was hesitant about staff supporting them with some aspects of personal care. The relative told us, “The staff do understand this, they take their time with them.” People and relatives were involved in reviewing the care planned and provided, so care plans continued to reflect any changes in people’s wishes and preferences. Staff took time to ask people what care they would like and responded to people’s wishes. Staff gave us examples showing how people’s emotional and physical support was tailored to suit them. A staff member said, “You need to go with their needs it's not the same for everyone.” Other staff told us about the ways they had changed people’s care when they needed more support after bereavements, and how staff encouraged people to be involved in sharing their lived experiences during staff meetings. This helped staff to understand how people’s health diagnosis impacted upon people. However, we found some instances where people's care plans did not always record things which may make people anxious, or let staff know how to support the person when this happened. We spoke to senior staff about this and they gave us assurances they would address this without delay.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People told us they were provided with the support they wanted so they could live their lives as they wished. One relative highlighted if the planned hours of care were not provided, staff contacted them and arranged a review meeting to address this. People and their relatives told us there had been changes to the staff providing care and leading the service and said these changes had been positive, resulting in improved care for people. New staff told us they were supported to get to know the people they cared for and had become key workers for some of the people they supported. This helped to ensure people were cared for by staff who knew them well. Senior staff explained they ensured people were cared for by a consistent staff team, whilst ensuring people had the opportunity to develop caring relationships with other staff members. This gave people had chances to get to know staff who may care for them in the future, and to make informed choices about which staff they wanted to have assistance from. Partners told us they were able to contact senior staff and the registered manager, who knew people well. Partners gave examples showing how staff contact them to advocate appropriately for people when this was required. For example, in relation to changes in people’s support needs which required additional hours to be funded, and to seek specialist advice so people would have the support they needed. Systems were in place to provide training to staff so they had the skills and knowledge to care for the people they supported as people's needs changed.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Some further development of systems was required to ensure people’s information preferences were promptly updated when people’s needs changed. People told us staff worked with them to understand what good communication looked like for them. People said staff listened to them. The majority of relatives told us communication with the staff team was regular and in a format agreed with them. People’s care records were securely stored. Staff told us most people currently receiving support did not require specific communication aids or equipment. Staff explained where people needed assistance with communication, for example, to make choices and to plan their care, they considered people's body language and offered them physical objects to choose from. One staff member told us they had previously supported a person with Makaton, but explained this was no longer required, as the person's communication preferences had changed. Staff were confident if people required additional communication support this would be provided. Staff gave us examples showing how people's right to privacy of information was respected. This included people deciding who they wanted to attend their care reviews. Systems were in place to identify people’s communication needs and preferences. Processes were in place to advise staff what support people required to promote good communication. People's communication plans considered if any diagnosis, sensory need or protected characteristics may may affect their ability to communicate. However, we found one person’s communication preferences had changed, and this had not been reflected in their care plan. Senior staff agreed to update the person’s care plans in response to our feedback.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support, but staff did not always tell them what had changed as a result. Most people and relatives told us they had not needed to make formal complaints because the quality of care provided was good. However, one relative raised a concern regarding an informal concern they had raised and how the outcome had been communicated to them. The registered manager took immediate steps to resolve this. Staff knew what action to take if they received any concerns or complaints about the care provided. They understood their responsibility to escalate the concerns to senior staff members, so appropriate action would be taken. The systems used to provide the registered manager with oversight of concerns and complaints received were not fully embedded. This increased the risk complaints would not be consistently responded to within the timescales set out in the provider’s policy, or to ensure any patterns, themes or trends would be appropriately actioned. However, systems were in place to support people to raise concerns and make complaints about the service provided. Processes guided staff in how to respond to both formal and informal complaints and to signpost complainants to other organisations who also had responsibility for investigating these. The registered manager had investigated individual complaints and responded to these, where complaints had been communicated to them.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People’s protected characteristics were considered at all stages of their care from the service. Most people received services which had support from staff available on a 24-hour basis. Staff and leaders gave examples of adjustments they had made to support people where they did not have access to staff on a 24 hour basis. This included collaborative working with external health and social care professionals to ensure people had access to the level of support they wanted. Staff gave us examples showing how they had advocated on people’s behalf so they would have the duration and timespan of care they needed, services and equipment required to maintain their quality of life. Staff outlined how they supported people so their equity in accessing services would be promoted. One staff member gave us examples showing how they had supported a person to seek support during times when staff were not usually on shift. They had worked with the person to devise strategies to assist person. This included equipping the person with new skills and by encouraging the person to acknowledge areas where they were independent. This reduced the person’s anxiety. Another staff member explained they had considered all of a person’s needs and preferences when reviewing if a ground floor bedroom was more suitable for a person, as their needs changed. Systems were in place to review if people wanted support from other health and social care providers and to support people to access these. Processes were in place and were followed for making referrals to specialist services when assessed to be required.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. However, some further development of systems was required in order to ensure information about people was consistently communicated to all other health and social care professionals. People were now supported to express themselves, engage in things they liked to do and maintain their wellbeing and health. Relatives told us their family members were now achieving better outcomes and enjoying life more. Staff considered people’s protected characteristics when working with them to plan and provide their care. One staff member explained how they supported one person with learning disabilities and told us, “I’m in a good rhythm with [person’s name]. I know what to do. I make sure they live how they want to. [Person’s name] likes to listen to music when they dress, so we do this.” Another staff member outlined how they had supported people to express their themselves and form bonds and relationships with others and live a more fulfilled life. Systems were in place to promote people’s rights and to communicate essential information about what mattered to people with other professionals. This included health action plans and hospital passports. However, the systems to support a consistent approach for staff to communicate information to other care professionals did not always work well. This increased the risk people who cannot express themselves may be disadvantaged when receiving care from other services. Senior staff told us they were refining their processes and practices to further support people to have the information and items they needed when they were going to receive support from other services. For example, some people now had dedicated hospital bags, which contained items and information important to them.

People were beginning to be supported by staff to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Some people’s wishes at the end of their lives had started to be considered by staff, with relatives consulted as part of the process. Where people or relatives had not wished to discuss this with staff at the time discussion was offered, this was respected. However, some relatives told us they would now like to consider their family member’s wishes at the end of their lives. Relatives advised us they were empowered to communicate their view and would discuss their family member’s wishes with staff. This would help to ensure their family members would have the support they wanted, when needed. Senior staff gave us examples showing how they had supported people and staff when people had experienced sudden, life threatening illness. One staff member said, “[Person’s name] was fine, but at least we were prepared.” Staff gave us assurances they would further develop people’s plans for the future, based on their knowledge of what mattered to people. Systems were in place to begin to explore people’s future plans with input from those closest to them. Processes were in place to train staff to provide end of life care, when required. However, further information based on staff knowledge of people’s preferences needed to be recorded on their care plans. Senior staff gave us assurances they would record this information on people’s plans and continue to offer relatives the opportunity to be consulted on their family members' future care.