Date of assessment 1 October 2024 to 13 January 2025. The assessment was carried out to check whether the Warning Notices issued at our last assessment had been met. We found the service had made some improvements and the provider was no longer in breach of regulations. We looked at 7 quality statements related to safe and well led. Lifeways Community Care (Swindon) is part of a national organisation which provides care to people with learning disabilities living in different communities. 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. We found the model of care was not always in line with current best practice guidance right support, right care, and right culture. Some staff still raised concerns about day-to-day support for new members of staff and told us this affected the planning for people accessing activities they enjoyed. We found the service was not following best practice guidelines in relation to storing medicines in supported living accommodation. Although the service had increased management support available since our last assessment, this was not yet fully embedded. The provider was taking steps to address this through training and development opportunities for new managers. However, people were now being appropriately safeguarded, and there were enough staff to support people. The service had introduced new initiatives since the last assessment, such as adapting the digital system to ensure prompts were available to investigate safeguarding incidents and manage audits.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-222812083.
Date of assessment 11 January to 21 February 2024. Lifeways Community Care (Swindon) is part of a national organisation which provides care to people with learning disabilities living in different communities. The Swindon office manages supported living services for people living in the area of Swindon and Gloucestershire. Systems and processes were not always in place to keep people safe. Incidents were not always responded to appropriately and there was a lack of oversight of risk. Staff were recruited safely and had completed most mandatory training. We found that staffing levels did not always meet people’s funded hours, and staff told us this impacted people’s ability to access the community and receive 1:1 support. People’s medicines were not always managed safely. Assessments of people’s capacity had not always been carried out appropriately to assess whether people could make decisions about their care. However, we observed staff offering people choices and supporting people in a way that promoted their independence. Audits were not always effective in identifying concerns relating to the management of the service. Staff raised concerns about the lack of management oversight in all services. Regulatory requirements were not always met by managers working at the services, such as appropriately responding to safeguarding concerns and rectifying concerns found at the last inspection.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-222812083.
Lifeways Community Care (Swindon), a supported living service for 45 people with learning disabilities, was downgraded from Good to Requires Improvement following a breach of Regulation 12 (safe care and treatment) due to inadequate risk assessments, controlled patch rotation failures and a medication error by agency staff. Governance, oversight and care plan accuracy were inconsistent under new leadership and high agency use, though responsive care, safeguarding awareness and infection control remained good.
Concerns (11)
criticalMedication management: “One person using the service was prescribed with controlled medicines patches. However, rotation of the patches were not recorded by the service provider.”
criticalMedication management: “we saw a recent medication error where an agency staff member administered diabetes medicines to a wrong person.”
criticalMedication management: “one person refused their diabetic medicines four days in a row. There was no information on how this might affect the person's health and well-being. There was no evidence of staff contacting the person's GP or 111.”
criticalCare planning: “Another person had Type 2 diabetes and required medicines, but these were not detailed in the person's care plan. This information was also missing in the person's hospital passport”
moderateCare planning: “Some people's care plans were out-of-date or did not contain important information regarding their health and well-being.”
moderateRecord keeping: “Records related to people's care were not always accurate or up-to-date.”
moderateGovernance: “Governance processes were not always effective in identifying shortfalls. For example, we found areas for improvement in care planning that were not identified prior to our inspection.”
moderateStaff competency: “We were not reassured that staff, agency staff in particular, understood the person's condition.”
moderateLeadership: “the success of this approach had been affected by changes in leadership at the service and the high use of agency staff.”
minorStaffing levels: “some people told us that due to the funding they felt restricted by low staffing numbers.”
minorCommunication with families: “I don't receive any phone calls, letters or emails from them, I don't feel I am kept up to speed on medical issues”
Strengths
· Staff trained in safeguarding and knew how to recognise and report abuse
· Effective infection prevention and control with appropriate PPE use
· Good complaints policy with lessons learned shared across the team
· Strong communication support including individual communication plans/passports
· Manager visible, approachable and responsive to inspection feedback
Quality-Statement breakdown (15)
safe: Assessing risk, safety monitoring and management; Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolation
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-222812083.
Not rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving care; Working in partnership with othersNot rated