Bolton Shared Lives

Bolton Shared Lives is a shared lives scheme which provides people with long-term placements, short breaks and respite care within shared lives carer's own homes. At the time of our inspection there were 73 people using the service, 39 of whom were living in long term placements. Shared lives carers are supported by care coordinators, who are responsible for the setting up, management and review of all placements.

People’s experience of using this service and what we found

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.

Right Support: People received care and support from carers who welcomed them into their home and family. Some people had lived with their carer for many years. Other people completed short breaks and/or respite with a consistent carer or carers, so had developed good, trusting relationships with them. Carers had a good understanding of people’s needs and how they wanted to be supported. People told us they were supported to achieve goals and aspirations. People’s independence was promoted, with people supported to access the community and activities in line with their assessed needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People using the service received person centred care which met their needs and promoted their dignity, privacy and human rights. Carers had the required skills and experience to provide care and were able to access additional support and advice from trained coordinators. The provider worked with other agencies and professionals to ensure and maintain people’s safety. Carers understood how to protect people from poor care and abuse.

Right Culture: The ethos, values and attitudes of both the service and shared lives carers ensured people were able to lead inclusive and empowered lives. There had been a number of recent changes to the management structure of both the service and provider, including the appointing of a new registered manager. However, people, carers and coordinators told us the changes had not impacted on how the service operated nor the level of support provided. Carers spoke positively of the support they received and the culture within the service. People and carers views were sought with feedback provided on how the service would make improvement based on information received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service was good (published 14 October 2017).

Why we inspected

We undertook this focused inspection to assess whether the current rating of good was still accurate. This report only covers our findings in relation to the key questions safe and well-led, as these were the only key questions inspected. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bolton Shared Lives on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Bolton Shared Lives offers a range of services including day time support, short term care where the person goes into the home of carer for a specific period of time and longer term care when the person goes to live with a carer as a member of the family and this becomes their permanent home.

People who use the service are adults over the age of 16 and need support with day to day living because they have a disability, mental health problem or are frail.

There was a registered manager in place at the service. 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 recruitment process for staff members and carers was robust to help ensure people employed were suitable to work with vulnerable people. There was an appropriate policy and procedure in place for safeguarding, issues were reported as required and staff and carers undertook appropriate training.

Accidents and incidents were reported and recorded appropriately. Actions to follow up were undertaken where required. People’s needs were thoroughly assessed and risks and needs recorded appropriately. We saw thorough risk assessments with techniques and actions to minimise risks documented within people’s care plans.

There was a medicines policy in place and full training was given to carers to help ensure medicines were given safely.

There was a thorough staff induction process, training was on-going and mandatory courses refreshed regularly. People wishing to be carers in the community were subject to an assessment and 8 to 10 weeks of pre-approval classes in a wide range of areas.

Care plans included relevant health information and support needs of people who used the service. Consent and agreement, when required, was sought from people who used the service.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). People’s best interests were considered when decision making took place.

We observed friendly and relaxed interactions between carers and people who used the service, who spoke about the placements as ‘home’ and told us they were very happy. Carers demonstrated a high level of empathy and compassion towards the people they cared for.

People were supported with the underpinning values of equality and diversity. Confidentiality was respected by all staff and carers. People who used the service were afforded respect by their carers and we saw examples of people’s dignity being respected within the visits we made.

If people in long term placements were approaching the end of their lives, they would be supported to remain in their home, with support for the carer, if this was their wish.

The service endeavoured to match people who required the service to carers with whom they would be compatible. Where multiple placements were made within one household, the dynamics of the group already together was considered to help ensure all the people being cared for were able to receive the correct level of support.

Care plans were person centred and included information about people’s backgrounds, families, abilities and strengths, choices, likes and dislikes.

There was an appropriate complaints procedure in place and complaints and concerns received had been followed up in a timely manner with appropriate actions.

There were clear values of equality, diversity, respect and dignity running through the organisation and this was reflected in all the observations, documentation and discussions with staff and carers.

Staff were supported with regular supervision sessions, where learning needs and personal development could be discussed. Effective systems for monitoring quality were in place. A number of audits were undertaken regularly to help ensure continual improvement to service delivery.

The registered manager was in regular contact with other Shared Lives services, including Shared Lives Plus. This helped her learn about and share good practice with other similar services.