Shared Lives Derbyshire

Updated 28 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 announced comprehensive inspection was carried out on 6, 12, 13 February and 23 March 2018. The inspection was completed by one adult social care inspector. On the 6 February the lead inspector was accompanied by another inspector who shadowed the inspection process. The provider was given 48 hours' notice prior to the first day of the inspection. This was because the registered manager spent time in the community supporting shared lives carers and we needed to be sure that someone would be available to speak with us.

This service is a shared lives service. It supports adults with a learning disability or autistic spectrum disorder to live in the community, in the family home of their shared lives carer. The Care Quality Commission (CQC) regulates the provision of personal care for people who use the service.

Before the inspection visit we looked at all of the key information we held about the service, this included whether any statutory notifications had been submitted. Notifications are changes, events or incidents that providers must tell us about.

We 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 also checked what information Healthwatch Derbyshire had received on the service. Healthwatch Derbyshire is an independent organisation that represents people using health and social care services.

In addition, we phoned the homes of four shared lives carers; people who used the service were not available to talk with us so we spoke to their carers. We visited a day centre and spoke with four people who lived in full time shared lives arrangements. We also spoke with the registered manager, the service manager and administrator for the scheme.

We looked at the relevant parts of three people’s care plans and reviewed other records relating to the care people received and how the agency was managed. This included quality assurance checks, staff training and recruitment records. The registered manager sent us further records for our review as part of the inspection.

Updated 28 April 2018

Shared Lives Derbyshire is a local authority operated service that supports adults with a learning disability or autistic spectrum disorder to live in the community, in the family home of their shared lives carer. Shared Lives schemes offer an alternative to both residential and more traditional care at home services for people who need personal care and support with their day to day lives. The Care Quality Commission (CQC) regulates the provision of personal care for people who use the service.

At the time of the inspection Shared Lives Derbyshire was involved in supporting people with a learning disability or autistic spectrum disorder who were settled in long-term placements or who took short respite care breaks. The provider is responsible for appointing, training, monitoring and supporting local carers who are self-employed and receive a payment for providing people with personal care, accommodation and other assistance.

This inspection took place on 6 February 2018 and was announced. The provider was given 48 hours’ notice of our intention to conduct the inspection, as we wished to ensure key staff would be available to contribute to the inspection. Telephone calls to shared lives carers were completed on 12 and 13 February 2018. On 23 March 2018 we visited four people at a day centre who lived in full time shared lives arrangements.

At our previous inspection in July 2017, we found one continued breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a warning notice in relation to the key question, ‘Does the governance framework ensure that responsibilities are clear and that quality performance, risks and regulatory requirements are understood and managed?’ At this inspection we found improvements had been made and the service now met this regulation.

Systems and processes were now in place to check on the quality and safety of services, including medicines administration, with carers trained in medicines administration and medicines administration records kept. Carers training was now monitored to ensure carers met the training requirements set by the provider. Policies specific to the governance of the shared lives scheme were now in place.

People made decisions in relation to their care and support and received support to enable them to be as involved as possible; where people needed support to make decisions their rights were protected under the Mental Capacity Act 2005; we found this had been followed for most people. Care plans were reviewed with people and their carers. People understood their care and support because carers worked with other professionals to ensure people received information in a way that they could understand.

The service is required to have a registered manager. 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. At the time of our inspection there was a registered manager in post. The registered manager understood their responsibilities for the management and governance of the service. The service was focussed on achieving good quality outcomes for people. The service was managed with an open and transparent culture where people were listened to and carers were valued.

The provider had systems in place to enable carers to recognise and respond to allegations or incidents of abuse or harm. Risk assessments were in place to identify day to day risks, as well as risks associated with people’s health conditions; actions were taken to reduce these known risks. Recruitment processes helped to ensure carers were suitable for their role. Processes were in place to match people to suitable carers and therefore carers had sufficient time to care for people. Where carers administered medicines to people, they had received training and understood what records they were required to keep. These were checked by staff at the Shared Lives scheme. Carers were knowledgeable on what actions to take to prevent and control any infections.

Carers received training in areas relevant to people’s needs and received support through meetings and regular contact with the shared lives staff team. People’s health and any associated risks were monitored and responded to by carers who involved other healthcare services where this would be of benefit. Where carers helped people with their meals, this was done in a way that promoted people’s involvement and independence and respected their choices and preferences.

A ‘matching process’ took place to help ensure people were cared for by carers who they could share interests and hobbies with; as a result carers reported they had positive relationships with the people they cared for. Some carers had cared for people since they were very young and were now adults; carers spoke genuinely of people being a part of their family. People were cared for in family settings by carers who were caring. Carers spoke about the importance of promoting people’s independence and how they respected people’s privacy and dignity.

Assessment of people’s diverse needs, including in relation to protected characteristics under the Equality Act, for example in relation to any disabilities people had, were considered in people’s care plans with them. People and their carers contributed to reviews of their care and support. This helped to ensure people did not experience any discrimination.

Carers and people were given information on how to raise issues or concerns, including complaints. Where feedback, including complaints had been received, systems were in place to ensure people’s views were listened and responded to.