Newham Shared Lives Scheme

Updated 8 August 2018

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 took place between 26 and 28 June 2018 and was announced. The provider was given 48 hours’ notice of the inspection as the staff team are often out during the day and we needed to be sure someone would be in.

Before the inspection we reviewed the information we already held about the service. This included registration information, the previous inspection report and information from notifications the provider had submitted to us. Notifications are information about incidents and events that providers are required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with two people who lived in shared lives arrangements and five shared lives carers. We spoke with three shared lives officers and the registered manager. After the inspection we spoke with a representative of Shared Lives Plus. Shared Lives Plus is a membership organisation supporting shared lives schemes, carers and people living in shared lives arrangements. During the inspection we reviewed the care and support files for three people living in shared lives arrangements and three sets of shared lives carer records. We reviewed staff and shared lives carers training, support and supervision records. We reviewed various meeting minutes, records, policies and other documents relevant to the management of the service.

Updated 8 August 2018

The inspection took place between 26 and 28 June 2018 and was announced. At the last inspection in July 2017 we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as risk assessments were not robust and there was insufficient information about people’s medicines. We also made a recommendation about ensuring people were involved in reviewing their care. The provider had taken clear and effective action to address these concerns and followed our recommendation.

Newham Shared Lives Scheme is registered to provide people with personal care. A shared lives scheme facilitates arrangements between people with support needs and shared lives carers who accommodate people in their own homes. Not everyone using Newham Shared Lives received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’. This is help with tasks relating to personal hygiene and eating. Where they do, we also take into account any wider social care provider. At the time of our inspection 52 people were living in long term shared lives arrangements, 18 of whom received support with personal care. A further 15 families regularly used the service for respite or short breaks.

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.

Newham Shared Lives was exceptionally run in a person-centred and innovative manner that focussed on achieving outcomes for people living in shared lives arrangements. The unique governance structure established when the provider became an independent not-for-profit company having previously been an in-house local authority service enabled positive risk taking in strategic development that benefitted people and shared lives carers. As a membership organisation the views of shared lives carers and people who used the service were central and shaped the values and priorities of the organisation. There were clear plans in place to increase participation and ensure sustainable growth in line with best practice guidance for the sector.

Staff and shared lives carers received high levels of support and training to ensure they had excellent skills that met the need of people living in shared lives arrangements. Staff and shared lives carers had been supported to complete externally accredited nationally recognised qualifications. Where people living in shared lives arrangements had specialist needs staff sought additional training for shared lives carers to ensure they could meet their needs. Shared lives carers told us this benefitted their entire families as well as the person they were supporting. Needs assessments for people were holistic and highly personalised ensuring the resulting care plans were outcome focussed and considered all aspects of their lives in addition to their care needs. The process of matching people with shared lives carers was led by people who had the final say on agreements. Peoples dietary needs and preferences were clearly captured and through the matching process the provider ensured dietary needs and preferences were met. Staff supported people and shared lives carers to meet their healthcare needs and supported them to access specialist support and services where this was needed. Records showed staff facilitated shared lives carers inclusion in people’s wider support networks and ensured all organisations involved in providing support to people worked together in a holistic way. The provider ensured shared lives carers understood the Mental Capacity Act 2005 and how it applied to people living in shared lives arrangements. Where people lacked capacity to consent to their care and treatment records showed clear best interests decision making processes had been followed.

People told us they felt safe living in shared lives arrangements. Shared lives carers were knowledgeable about safeguarding adults and knew how to report their concerns. The provider took appropriate action to ensure people were protected from abuse. Risks faced by people were identified with clear risk assessments in place to mitigate risks. The recruitment and assessment of shared lives carers was robust and comprehensive. It ensured shared lives carers were suitable and safe to provide care to people. There was clear information about the support people needed to take their medicines safely and people were supported to increase their independence with taking their medicines. Staff checked the homes of shared lives carers to ensure people were protected by the effective prevention and control of infection. When incidents occurred the provider took action to ensure lessons were learnt and incidents did not recur.

People and shared lives carers emphasised the importance of family and ensuring people felt like valued members of the household. People’s emotional needs were supported and they told us they felt valued. People’s relationships were supported and facilitated, including parenting responsibilities. People had felt comfortable to disclose their sexual and gender identity and the provider ensured people received the right support to express their identity. People were given privacy and felt they were treated with dignity.

People told us they were involved in reviewing and updating their care plans. People were supported to identify new goals once they achieved their previous ones. If people wished to move on from shared lives arrangements the service facilitated this and provided appropriate support to shared lives carers. People were supported to attend activities of their choice and the provider also hosted activities for people and their shared lives carers. People and shared lives carers knew how to make complaints and there was a robust system for managing complaints. There was a clear policy framework that aligned with best practice principles for supporting people at the end of their lives. Where people had expressed their views about end of life care this was clearly recorded.