This inspection took place over 18, 19 and 20 July 2017 and was announced. The provider was given 48 hours’ notice for the registered manager to make arrangements for us to visit the office, meet with people, talk with shared lives carers and review records. We visited the premises on 18 and 20 July and made phone calls to shared lives carers on 19 July. We visited some people who used the shared lives scheme at a day centre on 18 July. The service provides personal care to people who live with shared lives carers in their homes either on a full time or short term basis. The service operates across Derbyshire. At the time of this inspection 44 people were cared for in full time arrangements and 31 people in short term care.
Not all shared lives carers who administered medicines had received training in medicines management and had received clear instructions to record any medicines administered to people.
Therefore evidence to show all people received their medicines as prescribed was not complete.
This meant not all people had complete and accurate records of their care; as a result, systems and processes to assess, monitor, improve, identify and reduce risks were not effective as records reviewed of people's care were incomplete. In addition, systems to ensure effective audits of MAR charts were not in place.
Policies and procedures concerned with ensuring the quality and safety of services were not fully adopted and embedded for the shared lives Derbyshire service.
Improvements had been made to ensure shared lives carers received training in other areas identified as required by the provider. Where training was still outstanding, this was identified and monitored to ensure steps were taken to complete the training.
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 place.
People felt safe with their care and support. Risks were identified and actions to manage risks were in place, for example any risks associated with health conditions.
Recruitment checks were in place for the recruitment of shared lives carers. These checks helped the provider make safer recruitment decisions.
Processes were in place to manage any accidents and incidents should they arise.
The provider had a policy and procedure in place on the Mental Capacity Act 2005 to follow, should a person not have the capacity to consent to their care. Shared lives carers sought people’s consent before they provided care.
People had sufficient food and drink that met their preferences. Records showed any specific dietary needs, such as the need for a diabetic diet, were identified and met. Shared lives carers were aware of people’s healthcare needs and supported people to access other healthcare provision when required.
Shared lives carers felt supported by the registered manager and members of the shared lives team and had regular contact with them.
People felt cared for by their shared lives carers and felt included in planning their lives together.
Shared lives carers understood people's needs and how to meet these. In addition people's hobbies and interests were known and supported. People knew how to raise any worries or concerns, and had been able to do so. People received personalised and responsive care.
Shared lives carers respected people’s dignity and privacy and promoted their independence. The shared lives project manager promoted awareness of dignity in care and had become a dignity champion. People were involved in planning and reviewing their care and support.
The shared lives team promoted open and inclusive ways of working where opportunities for people and shared lives carers could contribute to the development of the service. Further developments to ensure people's experiences of care could be measured and used to inform the service were planned.
We found one continuing breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of this report.