The inspection took place between 6, 7 and 8 November 2018 and was announced. This meant we gave the provider a short amount of notice (48 hours) that we would be visited the office in order to ensure a manager was present and to seek consent in advance from people who used the service in order to visit their homes.

At the last inspection in May 2016 we found the provider was rated overall as good. At this inspection we found the provider was still overall good with responsive improving to outstanding.

Lifeways Community Care (Halifax) provides support for people with a range of disabilities and complex needs. The service provides supported living services for people living across West and North Yorkshire and East Lancashire. The service aims to enable people to live independent and dignified lives, by the provision of care within their own homes. At the time of inspection there were 59 people receiving a personal care service.

A registered manager was in place. 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.

We found strong evidence the service actively sought the views of people using the service through innovative methods, fully involving them in the interviewing process for new staff, and knowledge sharing. We found an extremely dedicated and knowledgeable management team committed to ensuring people could live as fulfilling lives as possible. Staff showed consistent attention to detail which meant people received a good level of care and support that was completely centred on everyone’s needs. This promoted people's health and wellbeing and enhanced their quality of life.

People said the standard of care was excellent and they were extremely well cared for. People spoke very highly about staff, the support they received and opportunities available to them. People had developed exceptionally strong relationships with staff. Staff including management knew people very well and consistently helped them achieve their dreams and aspirations.

The service had strong links with the local community. This empowered people to be involved in events and activities which took place in the local area. Due to the resources available and dedication of the staff team, people had access to an exceptional range of activities. These helped people achieve their dreams and build self-confidence. The service was exceptional at helping people develop their independence through a series of well thought out goals. People were fully involved in the planning and setting of these goals. People's achievements were celebrated by the service to help build further confidence. People were proud to tell us of their achievements.

Staff had opportunities to update their skills and professional development. Staff demonstrated an understanding of the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were confident in supporting people with medicines and knew people very well.

There was a clear management structure and staff clearly understood their roles and responsibilities. There was an open and transparent culture in which staff felt valued and able to approach the registered manager. Staff told us they felt valued and really enjoyed their role. The management team continued to improve and work as much as possible with people’s relatives if they had any concerns or complaints. We saw accident and incident reviews where lessons learnt had been applied through the review of these.

Further information is in the detailed findings below

The inspection took place between the 3 and 9 May 2016 and was announced. This meant we gave the provider a short amount of notice (48 hours) that we would be visited the office in order to ensure a manager was present and to seek consent in advance from people who used the service in order to visit their homes.

At the last inspection in May 2015 we found the provider was compliant with the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, but identified a number of improvements were needed to ensure people received good health and support outcomes. At this inspection, we checked whether these improvements had been made.

Lifeways Community Care (Halifax) provides support for people with a range of disabilities and complex needs. The service provides supported living services for people living across West and North Yorkshire and East Lancashire. The service aims to enable people to live independent and dignified lives, by the provision of care within their own homes.

A registered manager was in place. 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.

Since the last inspection a new registered manager was in post. We found a number of improvements had been made to the service since the previous inspection. Care plan documentation was more comprehensive and person centred. The service had improved the way it engaged with and involved people who used the service.

People all said they felt safe whilst using the service. Staff understood how to identify and act on allegations of abuse. Where safeguarding incidents had occurred appropriate action had been taken to help keep people safe.

Since the previous inspection, risk assessment documentation had been overhauled and was now more comprehensive and person centred. Staff had a good understanding of how to look after people in a safe way.

There were sufficient quantities of staff deployed to help ensure people were kept safe and in order to support them to achieve good health and support outcomes. Staff were recruited safely to help ensure they were of suitable character to work with vulnerable people.

Overall medicines were managed safely. In most cases people received their medicines as prescribed, although we did identify some concerns at one supported living property. Prompt action was taken by the registered manager to investigate these concerns and put measures in place to prevent a re-occurrence.

Overall, care and support was delivered by staff who had the right skills and knowledge to care for people. Staff received a range of training and support tailored to their role. However some relatives told us that changes to the staff team led to inconsistencies in the level of care and support.

People were supported appropriately to maintain a healthy diet. People were involved as much as possible in the sourcing and preparation of food to help develop life skills.

People’s healthcare needs were assessed and detailed plans of care put in place. People had access to a range of health professionals to help support their health.

The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, best interest processes had been followed to ensure people’s rights were protected. The service had worked with local authorities to submit applications to the Court of Protection where they thought people were potentially being deprived of their liberty.

People and relatives told us staff were kind and caring and treated people well. This was confirmed in the observations of care and support that we observed.

People’s likes, dislikes and preferences

On the day of our inspection we arrived at the service’s main office at 9am and met with the registered manager. They explained the service provided support for people with a learning disability who may also have other complex conditions, such as autism, Asperger’s or physical disabilities. The manager told us they were responsible for 10 supported living properties in Calderdale, three in Kirklees and four in North Yorkshire. They told us there were currently 66 people receiving personal care from the service. We spoke with staff and people using the service at the office during the morning of our inspection. In the afternoon we visited two of the homes where supported living accommodation was provided, we spoke with staff and people using the service.

During and after our visit we spoke with the quality manager, two care team leaders, two support workers, eight people using the service and two relatives of people using the service. Staff, people using the service and relatives all told us the care provided by the service was good and staff received appropriate training to carry out their role.

Comments from people using the service included:-

“I like living here; they take you out shopping, swimming and bowling. We go on the bus; I like buses.”

“I have a busy lifestyle and go to my dad’s house once a week to visit. I’m doing an IT qualification at Calderdale College.”

One relative we spoke with said, “They (relative’s name) has been all over in the past and they’re really settled now. Staff know how to deal with them and talk with them. They make us very welcome when we visit. They are well looked after.”

The other relative told us, “I’m absolutely thrilled; I think they staff are fantastic. I think my brother is beautifully looked after and the staff are so patient with them.”

Our visit found that people using the service experienced care, treatment and support that met their needs and protected their rights.

We also found there were effective systems in place to reduce the risk and spread of infection and infection control was well managed.

Evidence we were shown demonstrated there were effective systems in place to regularly assess and monitor the quality of service people using the service received.

We visited two homes that provided shared supportive living accommodation and we spoke with six people who use the service who all told us that they get on well with the staff and that staff supported them with their day-to-day needs. They are involved in the planning, delivery and reviews of their support plans of care. We spoke with a relative who was visiting at the time of our inspection. They told us about their previous concerns that they had with the service that had been dealt with by the managers and they spoke positively about the care currently provided at the home. They told us that they felt the services provided were to a good standard of care and the staff treated their relative with respect.

Lifeways Community Care (Halifax) provides support for people with a range of disabilities and complex needs. The service provides domiciliary care services, extra care housing services and a supported living service for people living across West and North Yorkshire and Lancashire. The service aims to enable people to live independent and dignified lives, by the provision of care within their own homes. Care is adaptable to suit each person’s needs, and ranges from a few hours each week to 24 hour care and support.

On the dates of the inspection, 12 to 19 June 2015, 76 people were using the service. At the last inspection in January 2014 the service was compliant with all the standards we looked at.

A registered manager was not in place. 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. The last registered manager had left in June 2015, and a new manager had just been recruited, who the service director told us would shortly apply to register with the Commission.

People and their relatives all told us that they thought the service was safe and nobody raised any safety related concerns. Staff understood how to identify and act on any concerns to keep people safe. Documentation we reviewed showed that safeguarding concerns were fully investigated by management and where shortfalls were found measures put in place to continuously improve safety.

Staffing levels were in line with commissioned hours. People and their relatives all said staffing levels were sufficient to ensure safe care, and staff raised no concerns in this area. Safe recruitment procedures were in place which included checks on candidate’s backgrounds to ensure they were of suitable character to work with people with learning disabilities. People who used the service were also involved in the recruitment process to ensure they helped select their carers.

Medicines were safely managed. Documentation showed people received their medicines as prescribed and regular checks were undertaken to ensure that good medicines practice was consistently maintained.

Staff received regular training in a range of mandatory subjects relevant to the care and support the people they supported received. Staff we spoke to demonstrated a good level of competency about the subjects we asked them about indicating the training had been effective.

Staff and management understood how to operate within the legal constraints of the Mental Capacity Act (MCA). We saw evidence that where people lacked capacity, meetings were held to ensure decisions made were in the person’s best interests in line with the requirements of the Mental Capacity Act (MCA).

Staff we spoke with had a good understanding of people’s healthcare needs and we saw evidence people had access to a range of health professionals. However information about people’s health conditions was not always present within people’s support plans. This meant there was a risk of inconsistent support in meeting their health needs. Health action plans were also not always robustly completed. A health action plan is a personal plan about what people with learning disabilities need to do to stay healthy.

People and relatives all told us that staff were kind and caring. Through discussions with staff and observing care we observed this was the case and staff showed a motivation to delivering kind and compassionate care. Staff spent regular time interacting with people and were able to develop close relationships with the people they cared for.

People had a range of health and support plans in place to help staff meet their needs. These included relevant information to help ensure people’s basic care and support needs were met. Although some people had well defined and relevant goals and objectives and performance against them was regularly evaluated this was not always the case. Some people had goals which did not match their present circumstances or there was a lack of proper evaluation of progress against set goals.

People and staff spoke positively about the management of the service and said they were good at dealing with any concerns or queries.

A range of audits and checks were undertaken by team leaders, service managers and the quality team. These were routinely identifying issues and action was taken to improve the service. However, some actions from audits conducted in 2014 had not been fully rectified within the set timescales.