Archived: Lifeways Community Care (Chorley)

Updated 23 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 the 6, 7 and 10 December 2018 and was announced.

The inspection was conducted by six adult social care inspectors.

This was a focussed inspection and was prompted by concerns raised with us about the safety of people who used the service. These concerns had also been brought to the attention of the Police and local safeguarding teams. We wanted to be sure people using the service were safe and that risks were being managed.

The lead inspector visited the service's main office on the first and second day of the inspection and a supported living scheme on the 10 December 2018. Other inspectors visited schemes run by the service throughout Lancashire and Cumbria. During the inspection we visited ten assisted living schemes, spoke with 20 people who use the service,15 members of staff, nine scheme managers and a representative of the registered provider.

Although the registered manager was unavailable during the course of the inspection, we spoke with them after the inspection and prior to the drafting of this report.

In preparation for the inspection, we reviewed the information we held about the service such as notifications, complaints and safeguarding information. We also spoke with representatives of local safeguarding teams and the Police. We also used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed a range of records about people’s care and the way the service was managed. These included the care records for 18 people, medicine administration records, staff training records, seven staff recruitment files, staff supervision and appraisal records, minutes from meetings and records relating to the management of the service.

Updated 23 January 2019

Lifeways Community Care (Chorley) is a supported living service that provides care and support to people living in 44 supported living settings in Lancashire and Cumbria, 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.

At the time of the inspection there were approximately 138 people using the service.

At the last inspection in January 2018, the service was rated as 'Good'.

We undertook this announced focused inspection of Lifeways Community Care (Chorley) on 6, 7 and 10 December 2018. The inspection was undertaken due to concerns raised with us about the safety of people using the service. We wanted to be sure people were safe and that concerns that had been raised were being managed. We inspected the service against two of the five questions we ask about services; is the service safe and is the service well led.

No other risks or concerns were identified in the remaining key questions through our ongoing monitoring or during our inspection activity between 6 and 10 December 2018 so we did not inspect them. The ratings from the previous comprehensive inspection for these key questions were included in calculating the overall rating in this inspection.

At the time of the inspection the registered manager was unavailable and had not been present at the service since September 2018. They returned to work prior to drafting this report. 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.

In the absence of a registered manager, the CQC had spoken with the provider prior to the inspection around concerns about the management of the service. As a result of this, the provider had put a senior manager from head office who was also a director in place who was managing the service. This person was present at the time of the inspection.

We initially became concerned about safety at the service when we were alerted about significant financial impropriety committed against people who use the service in the spring of 2018. The police, CQC and local authority safeguarding teams were kept informed of developments by the provider in the investigation into these matters.

During the course of the financial enquiry, we were advised by the provider that the registered manager was unavailable and that this was likely to be on a long term basis. We monitored that situation and during the same, became aware of concerns being raised by people, their relatives and social care professionals about the level of care and support that was being provided. This was in addition to the financial concerns we were already aware of.

Although we were satisfied that the provider had put steps in place to protect people using the service from further financial abuse and that the provider was reporting matters to the CQC, we were concerned about other issues. This included issues raised through contacts from staff employed in the service, a number of social care professionals and people who used the service and their relatives. All of these approaches to CQC raised similar concerns of poor staff attitude, lack of supervision and management and poor levels of care and support.

As a result of the additional concerns, we prepared to inspect and in so doing gave the provider 36 hours notice of the inspection as we needed to be sure that management staff would be available at the offices and schemes we visited during the inspection.

During this inspection, we found that the service was in breach of regulations in relation to failing to safeguard people from financial abuse, other safety matters including poor medicines management, staffing issues and poor management and governance. These breaches are under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and are summarised below. For full details, please refer to the 'safe' and 'well-led' sections of this report. You can see what action we told the provider to take at the back of the full version of the report.

The service was not safe because there had been failing in safeguarding people from financial abuse. The registered provider only established a robust system to prevent abuse after people had been put at risk.

On occasions, medicines administration had been poor because of failures of staff to follow policy and procedure.

We noted that some records were kept in relation to incidents that had occurred at the schemes run by the service. There was however a lack of management input, checking and investigation around these matters.

Staffing arrangements were not appropriate and records supported that some training, staff supervisions and appraisals were not taking place.

The service's registered manager had been unavailable for a substantial period of time and there was a lack of management oversight of the schemes and supervision of staff during this time .Staff and people who used the service also told us the service was not well run.

Training records we looked at showed that safeguarding adults was an annual, mandatory course but some members of staff had not been trained in this area for 12 months. Other safeguarding records we looked at showed that the registered provider had notified the appropriate authorities when a safeguarding concern had been raised. There were no concerns around the provider making appropriate notifications and fulfilling their related regulatory responsibilities.

We looked at how risks to people’s individual safety and well-being were assessed and managed. Care records contained risk assessments in relation to areas such as mental well-being and incidents but these were often out of date and had not been reviewed.

All the staff we spoke with, told us they had received training and were aware of their responsibilities in relation to infection control. The service had an infection control policy to guide staff in their roles and to reduce the risk of cross infection.

Throughout our inspection we were assisted by a senior executive from head office who the provider had put in place as an interim manager in the absence of the registered manager. Other senior staff from the head office had assisted in enquiries raised by CQC particularly around the ongoing financial investigation. At the inspection we saw that substantial work was being conducted into this and that the police were being provided with helpful material to assist them in the investigation.