Archived: Grace Eyre- Shared Lives, Sussex

The Grace Eyre Foundation provides support for people who have a learning disability and/or a mental health need, through shared lives services, day care, housing and domiciliary support.

Grace Eyre Shared Lives Scheme is registered to provide personal care and support, and provides a service in the Brighton and Hove, East and West Sussex area. The care and support can be for long or short term accommodation and short breaks. In shared lives, an adult over 18 years of age who needs support and/or accommodation becomes a regular visitor to, or moves in with, a registered shared lives carer. Together, they share family and community life and in many cases the individual becomes part of a supportive family. Shared lives carers and people they care for are matched for compatibility, personality, lifestyle knowledge of the carer to meet the needs and preferences of the person living with them and can develop real relationships. The shared lives carer acts as ‘extended family’, so that someone can live at the heart of their community in a supportive family setting. Approximately 79 people were supported in the scheme. Day share is also provided. This is where a shared lives carer can offer support in their home during the day for up to three people who do not wish to receive a traditional day service. An activity is provided for example, a social engagement, trips into the community, cooking or crafts. Not all the people received help with the regulated activity of personal care, but may be supported with for example, community participation and support with travel. Shared lives carers are supported and managed by a team of staff employed by the service based at the services office in Montefiore Road.

On the day of our inspection, there was 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.

There was a clear management structure with identified leadership roles. The registered manager managed two shared lives schemes run by the provider, and divided their time between both schemes. Staff told us the registered manager was always accessible and contactable when working at the other scheme via email or by telephone. One member of staff told us, “We are always checking in with him.” In this scheme the registered manager was supported by two deputy managers who were qualified social workers and who ensured initial assessments are carried out with new shared lives carers and worked with people who wished to receive a service. They set up new placements and worked with transitional cases where people were transitioning from children’s to adult services, with more complex cases, and led on any safeguarding issues identified. There were three shared lives co-ordinators, who undertook individual visits monitoring and supporting the shared lives carers, and they reviewed the care and support of the person or people in the placement. Each worked within a geographic area.

The organisation was outstanding as they strove to ensure the service was ‘service user led.’ There were a range of forums and accessible information to support and enable people to give their views on the care and support provided, and to be actively part of the development and running of the service. People were listened to and encouraged to give their views, which were taken into account and used to shape the service.

Care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence. People’s care and support plans were detailed and reviewed regularly. Detailed risk assessments were in place to ensure people were safe within their own home and when they should receive care and support. One shared lives carer told us, “We have detailed care plans. We get reviews quarterly. We can call up with any issue and they will come and discuss and look at the plan and update if necessary. (Person’s name) has been with us for 18 years so we know her inside out, although we have the care plans we know her very well as you can imagine.” Another shared lives carer told us there was a, “Regular review with the support worker and (person’s name) to ensure all is ok.”

People told us they felt safe in the service. People were supported by a shared lives coordinator and carers who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. There were systems in place that ensured this knowledge was checked and updated. One member of staff told us, “We have online training which is ok, and are trained in safeguarding and know what to do and who to contact.” Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Consent was sought from people with regard to the care that was delivered. Shared lives co-ordinators and carers understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests. Referrals had been made for Deprivation of Liberty Safeguards (DoLS) and we could see that staff understood how these were implemented.

People were supported to eat a healthy and nutritious diet. People had access to health care professionals and had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. Medicines were managed safely and people received the support they required from the shared lives carers. There were systems in place to ensure that medicines were administered and reviewed appropriately.

New shared lives carers underwent rigorous assessment and checks before being ‘matched’ with people who needed support. Peoples cultural needs were taken into account when they were matched with potential shared lives carers. People told us how they liked their accommodation and enjoyed living with their shared lives carers. One person told us, “I like where I live it is nice.” Another person told us, “I like it here.” Another person told us, “I am very happy in my home. It’s beautiful I would not want to leave there it’s my home. She is my carer, but she’s my family.” Another person told us, “I love my bedroom and TV.” One shared lives carer told us, “She has lived here for three years and it works very well.” People were supported to express their views and were involved in decisions affecting them. People were supported to stay in touch with family and friends.

People were supported by extremely kind and caring staff. One person told us they when they asked their shared lives carer, “Can I have a talk with you, and she says of course anytime. If there is anything I want to know she sits down and talks with me.” Another person told us,” There is no other better scheme.” Shared lives co-ordinators and carers were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. The majority of staff told us that communication throughout the service was good. One shared lives carer told us, “We get good communication from Grace Eyre.” The shared lives carers said they felt well supported by management and were positive and enthusiastic about their roles. One shared lives carer told us, “It’s hard work for everyone at Grace Eyre, but it’s all good and everyone cares.”

There was a detailed complaints procedure which was also produced in an accessible format to help people access the information they needed if they had any concerns they wanted to raise. The registered manager told us that they operated an 'open door policy' so people, their representatives or shared lives staff could discuss any concerns. The office was based alongside in the same building as other of the providers services such as the day care service. People were encouraged to come and talk with staff in the office about the service and any concerns they had when they were visiting the building. We observed a lot of interacts between people and the staff throughout the day during our inspection.

The registered manager, along with the deputy managers and shared lives co-ordinators provided good leadership and support to the shared lives carers. One member of staff told us, “They (Grace Eyre) are good what they do and people like you from the CQC. It makes me happy that people are cared and looked after as they should always have been. You all do a great job to ensure they get the care and support they need and they are just like you and me.” When asked if the service was well led one member of staff told us, “Definitely. We have a brilliant, open and accessible team. There is always someone to talk to and run things by.” Systems were in place to audit and quality assure the care provided.

During our inspection we spoke with four people who used the service as well as six members of staff. We spoke with the deputy chief executive, the regional manager, the registered manager as well as two shared lives carers and a senior shared lives worker. We also looked at surveys and meeting records to help us understand the views of the people who used the service.

One person who used the service we spoke with told us 'I get all the help I need, I am happy' another person told us 'I like where I live it is nice, I have everything I need'.

Shared lives carers we spoke with felt fully supported with Grace Eyre. One person told us 'I cannot speak highly enough of Grace Eyre, I have been a carer for many years and they are wonderful'. Another person told us 'I was impressed with the training, they were so informative'.

We also looked a paper based and electronic care plans, risk assessments, staff records and policies and procedures.

This told us before people had received any care or treatment they had been asked for their consent and the organisation's staff had acted in accordance with their wishes. People or their representatives had been involved in making decisions about their care and treatment.

People's care needs had been assessed and reviewed, and care and treatment had been planned and delivered in line with their individual care plan. One person told us 'There are plans to get ready for my review.'

People's care had been provided by shared lives carers who understood their care needs and who had been provided with training and support.

Robust recruitment practices had been followed. Appropriate identity and security checks had been completed as part of the recruitment process. One shared lives carer commented they had been through 'A very thorough recruitment process'.

The records needed for the management of the service had been maintained and were accurate and complete.