Archived: Guideposts Trust Norfolk & Suffolk Shared Lives Scheme

Updated 13 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection was carried out by one inspector. The provider was given 48 hours’ notice because we needed to be sure that someone would be in the office. Therefore the provider and staff operate from a central office and we needed to be sure that they would be on the premises so we could talk to them during the inspection.

Before the inspection, we reviewed the information available to us about the service, such as the notifications that they had sent us. A notification is information about important events which the provider is required to send us by law.

During the inspection, we spoke with the director of services, the regional manager and two members of staff. We also spoke with a healthcare professional who had regular contact with the services and four carers.

We looked at care records and associated risk assessments for three people and other documentation around the monitoring of the service provided.

Updated 13 January 2017

This was an announced inspection that took place on 15 December 2016, with follow up phone calls to carers on 16 and 19 December 2016.

Guideposts Trust Limited provides a 'shared lives' service for adults who need support and who want to live as part of a family or household. It is an alternative to residential care for people and provides a flexible form of accommodation, care or support inside or outside the Shared lives carer's home. It provides services for people with learning, physical or sensory disabilities and people with mental health problems. The service provides long term placements, short term placements and

For the purposes of this report we will refer to those who provide support to service users as 'carers'. The support workers from Guideposts, who provide support to these carers, will be referred to as ‘staff’.

respite care. It is responsible for co-ordination between the people who use the service and the carers with whom people live.

At the time of this inspection there were 132 people using the service. Of these, 63 were receiving personal care, which is regulated by CQC.

There was a registered manager 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 and associated Regulations about how the service is run. At the time of the inspection the registered manager was not at work, and the regional manager was overseeing the service with support from the director of services.

The service worked closely with social workers and health professionals who were involved in the care management of the people who used the service to ensure their needs were fully met. The staff directly employed to work for Guideposts were responsible for recruiting and reviewing carers who provided the care and support that people needed within their own homes. People received personalised care from carers who had been carefully chosen by the service to provide support to the person. The carers were supported by the service to do this effectively. They had received enough training to enable them to keep people safe and to meet their needs.

There were systems in place which identified whether carers had the training and support they required and to check whether people were satisfied with the service they received.

However, there was a lack of effective systems in place to monitor the accuracy of the records relating to people’s care. There was no system in place for ensuring that all service users had comprehensive support plans in place, which presented a risk that there was not always guidance for potential carers on how best to support people. Audits and spot checks that the registered manager had in place had not identified that this was an area in need of improvement.

There was not always good leadership in place. The registered manager had not always checked new staff training, and had not supported new staff to go through the comprehensive induction process expected by the organisation.

There were systems in place which promoted people’s safety which included ensuring that carers received training in safeguarding. The staff ensured that risks associated with people’s needs were assessed and mitigated as much as possible. They also ensured that they recruited carers who were deemed suitable to work with people and that their homes were safe for people to live in.

Where carers supported people to take their medicines, they received the appropriate support and training to administer these.

Staff and carers maintained regular contact to ensure that carers had the training they needed to deliver their roles, and where gaps were identified they carried out further training. Carers and staff were knowledgeable about mental capacity and the surrounding legislation.

People were supported to eat a healthy diet and carers supported people to follow their dietary requirements. Guideposts staff ensured that they gathered up to date information about people which included how they were accessing health care. Carers worked closely with health care practitioners and supported people to access health care when they needed.

Carers communicated with people in a way that enabled them to make choices, and involved people and their families about decisions relating to their care. They supported people to access the community and engage in activities that they enjoyed, and encouraged people to maintain their independence.

There was a system whereby carers reported to the organisation monthly or as needed, so that staff could support them with any advice and support when they needed it.