Lifeways Community Care (Warwickshire & Coventry)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People and staff worked together to identify any risks people may experience and to put measures in place to reduce risks. There were sufficient staff available to meet people’s needs. Staff were recruited safely and received training to help them to provide good care to people. This included how to promote people’s safeguarding and how to support people to maintain a safe and clean environment. People were supported to have their medicines regularly. There was one instance where a person’s medication protocol had not been reviewed as required. Senior staff took action to address this. Where lessons to be learned were identified these had been communicated to staff. However, we found processes to ensure opportunities for taking learning from incidents required further development and embedding.

This service scored 75 (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 had a positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and reported safety events. However, we found information was not always recorded, which increased the risk of learning opportunities being missed. Where lessons were identified, leaning was shared to develop the service further. People told us they felt safe and said staff took time to reassure them when they were anxious or upset. Relatives gave us examples of how learning was taken from incidents. For example, staff were aware of increased risks people faced when mobilising and how they could reduce these. Staff told us they felt supported and able to raise any concerns with the management team and were confident action would be taken. Staff told us staff told us they discussed if there was any additional action they could take to reduce risks to people after any incidents. Staff gave us examples showing how they took learning across the service, such as introducing additional fire safety checks. One professional said staff were good at communicating with them and updated them about changes and learning which effected people’s individual risks. One professional told us, “[They] have had a few medication errors.” The professional said the provider had taken learning from these and went on to say, “The correct protocols were followed and staff called 111 for advice.” The providers systems monitored some accidents, incidents and complaints. Where lessons to be learned were identified these had been communicated to staff. However, we found information was not always recorded, which increased the risk of learning opportunities being missed. For example, accidents and incidents were not always analysed. The manager assured us they would further improve their processes to include analysing patterns and trends.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved into the service. People told us they were supported to access medical appointments by staff. One person was supported to help make an informed choice which promoted their wellbeing and helped them to have access to the medicines they wanted. Relatives told us their family members were supported by staff to regularly receive care from other health and social care professionals, so there physical and well-being needs would be met. Staff worked with people and their relatives to consider people’s safety needs, before they started to receive care from the service. This included staff taking action to ensure a smooth and safe transition. This included showing people photographs of the service, if they were unable to visit in person prior to moving in, and arranging for them to meet new staff. External professionals told us the service supported transitions into the service safely and effectively. One professional said they received referrals from the provider when there had been a change in the person’s needs. Another professional told us feedback had been given to the registered manager regarding meeting a person’s personal care needs. The person's support plan had been promptly updated to ensure the required support had been put in place. Systems were in place to work with other health and social care professionals to identify people’s safety needs when they transferred from other services. Processes were in place to work with other health and social care professionals when identifying and considering people’s safety needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they were happy living at the service. Relatives spoke of new measures being put into place to safeguard their family members when needed. Staff understood their responsibilities to report any concerns to ensure people were safeguarded. One staff member said, “I would contact 111, 999 or the local authority depending on the circumstances.” Another staff member told us, should any concerns happen, “I have to safeguard and remove the person from any danger.” People looked well cared for and were at ease in the company of staff supporting them. They were relaxed and comfortable with other people using the service. We saw people were supported to be involved in day-to-day decisions about their safety and care. The registered manager understood their responsibility to report any concerns to the local authority and to the Care Quality Commission, (CQC), to ensure any allegations of, or suspected abuse, were investigated. There was a safeguarding policy in place, this had up to date guidance for staff on how to respond to any safeguarding concerns. Systems were in place to report and refer any safeguarding incidents to other organisations with responsibility for keeping people safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Some people undertook elements of their care but had staff support where this was required. For example, some people went out independently, whilst others required assistance from staff to maintain their safety. Families told us risks to people were manged well. Staff demonstrated they had a good understanding of people’s risks. This included how to support people so they did not become too anxious. Staff knew what their responsibilities were when supporting individual people to remain safe when managing their specific risks. People were supported by staff to have access to equipment they needed to stay safe. For example, where a risk assessment had determined a lap belt was needed to safely reduce the risk of falls, we saw this was in place. People had safe access to all parts of their living environment. Processes were in place to identify people’s risks and to put control measures in place to reduce the risks. Care plans demonstrated risks to people had been considered, such as the risk of choking. Staff had been given clear guidance on how to safely support people at different stages of any choking incidents. Systems were in place to assess people’s safety needs across a wide range of risks. These included people’s risks and support needs when managing their finances, assistance required to reduce the risk of self-harm, and social isolation.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care and worked with Local Authorities to ensure sufficient staff were available to support safe environments. People were supported to maintain a safe environment within their living area. One person had raised concerns around the security of their garden fence. Staff had reassured the person and liaised with the person’s landlord to address the concern. The person and staff had continued to monitor the building security and confirmed no further instances relating to the security of the fence had occurred. Families told us people were supported to maintain their tenancy and to report any repairs. One relative said, “Yes [person’s name] is safe in their environment.” Staff understood what action to take to support people to manage their environment safely. Senior staff told us people were involved in fire evacuation practices. A senior staff member said, “We do fire evacuation now monthly so everyone knows what to do, that’s staff and people.” They told us, “We do them often so its fresh in people's minds.” People had adaptations in place where this was required. People’s communal areas were clean and entry to some buildings were fob or key controlled, for added safety. Lifeways Community Care (Warwickshire & Coventry) is a supported living service. CQC do not regulate the premises which are the responsibility of the landlord. However, systems were in place to ensure the premises were safe and any tenancy matters were reported and progressed. The provider completed health and safety audits and undertook regular checks to monitor the safety of the premises and ensured people’s equipment was appropriately serviced. People had Personal Emergency Evacuation Plans (PEEPS) in place.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People said staff knew how to care for them. Relatives told us there had been a high turnover of staff and previously a lack of leadership. However, other relatives advised us there had been some improvements following the appointments of new staff. One relative said, “Things are now improving with the arrival of the new [senior staff members name].” Staff told us there were now enough staff on shift to meet people’s needs. Staff said they had received sufficient training to do their jobs safely, including Learning Disability and Autism training and to meet people’s physical health needs. Staff also had competency checks to ensure people had safe support with their mobility and medication. Staff said they felt supported. One staff member told us, “I have monthly supervisions, it’s enough and we can go to [senior staff] at any time.” Staff told us there were new staff who had joined the service, which had led to improvements in people’s safety and care experiences. One senior staff member told us, “[Person’s name] enjoys going shopping on a [set day], so we ensure a staff member is in to support them.” We saw people received support when they asked for it. Staff knew people well and communicated with them effectively. Systems were in place to assess the staffing levels needed, to ensure they met the needs of all people using the service. Procedures were being embedded to ensure people were supported by a consistent staff team. Processes were in place to ensure staff were recruited safely. The provider sought references and completed Disclosure and Barring Service DBS checks. This helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People were supported to maintain cleanliness of their own living areas. Relatives told us communal areas were clean when they visited. The senior staff team told us they undertook regular audits in infection prevention and control (IPC). Staff gave an example of how they supported people individually and were working with a person to maintain a clean environment and provided them with the support they needed to do this. The services visited were clean, tidy and free from infection. Staff followed good hand hygiene and washed their hands before supporting people with their meal preparation. People’s personal environments were respected and organised in a way they wished. Staff support was available when required promote good infection control. The provider had systems in place to safely manage infection prevention and control. Processes were in place to monitor practices such as staff spot checks and IPC audits. Staff had completed IPC training.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Some people self-administered their medication, other people wanted support from staff to have the medicines they needed to remain well. Staff supported people with their medicines in a safe and appropriate way. Staff completed training and underwent competency assessments, to ensure they knew how to safely administer people’s medicines. Staff knew what to do in the event of a medicine error, or if someone declined to have their medicines as prescribed. The registered manager told us there had previously been a number of medication errors, but these had reduced significantly after the introduction of new ways of administering people’s medicines, and staff being retrained. Medication practice was reviewed as a result of near misses and errors. This helped to ensure people received their medicines when they needed them and as prescribed. Staff checked if people wanted to receive any 'as and when required' medicines and respected people’s responses. Staff used their knowledge of people’s preferred way of taking their medicines when assisting them. Staff checked people had taken their medicine and recorded what had been administered. People were supported to have their medicines regularly. Staff sought advice from health professionals if they had any medicine concerns. However, we found an instance where staff did not have guidance in place for the management of a person’s medicinal creams. The risk of the person developing poor skin health was reduced because staff spoken with did have a good understanding about how to support the person with their medicinal creams. In addition, this person’s medication protocols had not been reviewed as required. Senior staff took immediate action to address this.