Date of Assessment: 18 March to 15 May 2025 The service is a supported living service providing personal care to people with a learning disability and autistic people living in their own homes. At the time of the assessment, 29 people were receiving the regulated activity personal care within 12 supported living services. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. We carried out this assessment in response to concerns we had received. The providers governance and oversight systems had not identified all concerns we found and ensured that all necessary actions had been taken following our last inspection. Although there had been some improvement, and the provider was no longer in breach of regulations concerning safeguarding and staffing. We found repeated breaches of regulations concerning safe care and treatment, consent, dignity and respect and governance. The provider’s governance and oversight systems had not identified concerns we found or ensured that necessary action had been taken following our last inspection. People were not always supported to have maximum choice and control of their lives and the culture within the service was not always positive. Where people lacked capacity to make decisions, the provider failed to follow the Mental Capacity Act (MCA) 2005 code of practice. People were not always protected from the risk of harm as staff did not always have all the information needed to meet people's needs safely. Care records viewed throughout the assessment were of mixed quality and improvements were needed to ensure medicines records were accurate and up to date. Safeguarding concerns had not always been responded to appropriately. People had their needs assessed when they first moved to the service, however people’s changing needs had not always been assessed appropriately. People were being supported by enough staff who had been recruited safely. The provider supported staff wellbeing. Staff provided information in a format people could understand. The registered manager was open, honest and responsive throughout the assessment, acting on any queries raised. We have asked the provider for an action plan in response to some of the concerns found at this assessment. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and or appeals have been concluded.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-16465562707.
Lifeways Community Care (Taunton), a supported living service for people with learning disabilities and autism, was rated Requires Improvement across all five key questions at its first inspection in August–September 2023, with regulatory breaches identified in dignity and respect, consent, safe care and treatment, safeguarding, governance, and staffing. Multiple critical failures were found including unlawful deprivation of liberty, unsafe medication management, inadequate post-incident learning, insufficient specialist staff training, and ineffective governance oversight placing people at risk of avoidable harm.
Concerns (12)
criticalSafeguarding: “Restrictions were placed on people without considering the principles of the MCA and there was not always clear evidence that the restrictions were in the person's best interest.”
criticalConsent / capacity: “The provider had failed to ensure care was provided to people in a way that ensured people were not unlawfully deprived of their liberty. This was a breach of Regulation 13.”
criticalMedication management: “One person was prescribed medicines covertly. This had been agreed by the person's GP in 2018. Although we had been told this had been reviewed, there was no evidence of this.”
criticalIncident learning: “Following 1 significant incident, staff involved did not receive a debrief for 7 weeks. This meant potential opportunities to learn lessons quickly when things went wrong, were lost.”
criticalStaff training: “Staff told us they had not always received adequate training to support people who experienced emotional distress. Not all staff had received training required for physical intervention.”
criticalGovernance: “Several governance audits completed by service managers were found to be inaccurate, and had not identified the issues found during the inspection e.g. concerns with medication, training, MCA and DoLS.”
moderateCare planning: “Care plans, risk assessments and positive behaviour support plans were not always being followed. 1 person's support plan had not been reviewed since 31 July 2021.”
moderateRecord keeping: “Records did not always detail what other options were considered or which option was the least restrictive. We found they had not always been reviewed.”
moderateStaffing levels: “Relatives told us, 'I am happy, or was, but there are not enough staff, and that's the crux of it' … registered manager was aware that commissioned hours were not always being met.”
moderatePerson-centred care: “1 record stated a person was requesting breakfast but was told they had to wait. Another record stated an incident occurred due to the person 'not getting their own way'.”
moderateComplaints handling: “We saw 1 example of where a concern was raised by a person in July 2023. This had not been acknowledged or responded to.”
minorSupervision / appraisal: “Staff received support in the form of continual supervision and team meetings, however this differed across the settings. Evidence was not always available to show when team meetings had been completed.”
Strengths
· Staff had training on how to recognise and report abuse and knew how to apply it, with confidence to escalate to safeguarding directly.
· People were supported to access specialist health and social care support, annual health checks, and had hospital passports in place.
· People were involved in choosing their food, shopping, and planning meals; nutrition information was included in support files.
· Most relatives were positive about the caring nature of staff, noting staff knew individuals well and supported them on difficult days.
· People's communication needs were clearly detailed in support plans with communication tools observed in use.
Quality-Statement breakdown (19)
safe: Systems and processes to safeguard people from the risk of abuse; Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Preventing and controlling infectionRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills, and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Requires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Respecting and promoting people's privacy, dignity and independence; respecting equality and diversityRequires improvement
caring: Supporting people to express their views and be involved in making decisions about their careRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and socially relevant activitiesRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Managers and staff being clear about their roles; quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersRequires improvement