Archived: Shared Lives

Shared Lives is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. At the time of our inspection there were 204 people who used the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

There were effective governance systems in place to identify concerns in the service and drive improvement. The registered manager did not always document their reviews of the quality systems, we made a recommendation about this.

People were protected against the risk of avoidable harm because potential risks to people’s health, safety and welfare were managed safely.

Peoples care and support plans were person centred and reviewed on a regular basis. Staff were trained to a good standard.

There were always sufficient staff to meet peoples needs. There was good planning and provision of meaningful activities for people.

People were supported by staff who were kind, compassionate and caring and who understood their likes, dislikes and preferences. People were happy living in a shared lives environment and told us they felt safe. People were supported to access health care professionals to maintain their health and wellbeing.

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.

The provider was responsive to our feedback and took action to make improvements in the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 this service was good (Published 5 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Shared Lives provides people with the opportunity to be part of the family of a Shared Lives carer. Carers are employed by the service to provide either a long or short term placements within their own homes. People that used the service had a range of health and social care needs, including a learning or physical disability.

When the provider completed their ‘provider information return’ they told us they supported 265 people in Shared Lives carer’s homes.

The service had a registered manager in post. 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.

People told us they felt safe and liked where they lived, telling us that they enjoyed being part of a family.

Staff, Shared Lives carer’s and people using the service were aware of safeguarding procedures and had received information to support this. Medicines that Shared Lives carer’s managed for the people they supported were administered in a safe way with some people being supported to self-administer their own medicines.

Risks had been assessed across the service, including risks to people and the premises in which they were living. The provider regularly updated these to keep people safe and visited carer’s and people within the home setting to monitor this.

Recruitment procedures were in place for staff and Shared Lives carer’s. These procedures had been updated recently with further on-going updates. This ensured that people were supported by staff and carer’s who had been checked thoroughly for their suitability to work with vulnerable adults.

The service had an approval panel in place, chaired by a person independent of the scheme and made up of a range of individuals. The panel was integral in assessing and approving prospective Shared Lives carer’s.

There were enough staff to provide support to Shared Lives carer’s with each area having a shared lives manager. People were only matched with suitable Shared Lives carer’s once the recruitment, training and panel confirmation process had taken place.

Staff had received induction and training and received regular supervision and yearly appraisals. Shared Lives carer’s received a full induction which had been recently updated. Their training process had been also been updated to ensure that all carer’s were skilled to meet the needs of the people they took into their homes to care for.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. We found the provider was complying with their legal requirements. Where people did not have the mental capacity to make important decisions, the scheme worked with other professionals to check that decisions made were in their best interests.

Staff we spoke with and the records we checked confirmed that people’s nutritional needs were met. People told us they enjoyed food they liked and were well looked after.

It was clear from conversations that people thought the Shared Lives carer’s were kind and compassionate and had welcomed them into their homes as members of their family. Staff at the service were passionate in the need to support carer’s to provide a high quality service to the people they cared for.

Shared lives carer’s recognised the need to support and encourage people to make decisions and choices whenever possible and we saw and overheard this through various conversations. People and their Shared Lives carer’s and families were involved in their care planning and records were reviewed regularly.

People and Shared Lives carer’s knew how to complain and easy read information was available to support people with additional needs. There had been no major complaints and minor complaints had been dealt with effectively.

We saw that there was a clear management structure in place and Shared Lives carer’s spoke highly of the Shared Lives staff team and the registered manager.

Monitoring systems were in place to ensure that the quality of the service was checked and any issues were actioned. The provider was in the process of launching some new changes to the service and this had been because of a full review of the service which had taken place with input from Shared Lives carer’s and utilising best practice from other Shared Lives services.

The scheme was well-managed and plans were in place to further develop the scheme to provide support to more people.

There was a positive culture and the team worked inclusively with people using the service, the shared lives carer’s, and other professionals. Systems were in place to obtain and act on feedback and make improvements to the quality of the service and learn from incidents. An independent panel had oversight of how the scheme was working to make sure that standards were maintained.

We also looked at 10 care files and the recruitment, training and supervision records of 10 sets of carers.

The people we spoke with told us they were happy with the care that they had received. A person who used the service told us "I like it here I wouldn't want to go back to where I was before, I want to stay here forever".

Another person who used the service we spoke with told us "I have been here 15 years and I love it. I would tell [my carer] if there was anything I wanted, she's lovely to me".

We found that the provider had ensured carers were trained in and responsive to any safeguarding issues. People told us they felt safe and were well cared for.

Carers that we spoke with had a good understanding of the support needs of the people who use the service. We saw that the recruitment process was thorough and enabled people to be 'matched' and suitable placements to be made.

The service had quality assurance systems in place to monitor the quality of the service provided and to gain the views of the people who used the service.