Shared Lives

Updated 9 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was undertaken by two inspectors and an assistant inspector

Service and service type

Shared Lives is a shared lives scheme, they recruit, train and support self-employed shared lives carers (SLC) who offer accommodation and support arrangements for vulnerable adults within their own family homes in the community.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 18 November 2019 and ended on 22 November 2019. We visited the office location on 18 November 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service about their experience of the care provided. We spoke with 11 self-employed shared lives carers. We also spoke with the registered manager, three shared lives staff, and the training manager.

We reviewed a range of records. This included six people’s care records, and reviewed accidents and incidents reports, surveys and questionnaires, safeguarding records, complaints and compliments, quality audits and action plans.

Updated 9 January 2020

About the service

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 the inspection there were one hundred and ten people living with shared lives carers and receiving a registered service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The provider had not ensured they had displayed their previous rating on their website as they are required to do by law.

People and shared lives carers were positive about the way the service was managed and told us this helped provide the support they wanted. The registered manager and staff checked the quality of support provided, so they could be sure people received the care they wanted, and care was provided in ways which promoted people’s independence. Staff reflected on their practice and were supported to work with people and other health and social care professionals to improve people’s support further. The registered manager planned future developments of the scheme in line with nationally recognised best practice standards.

People’s care plan and assessments reflected their needs and choices and were regularly reviewed. Shared lives carers and staff supported people to enjoy a wide range of activities, and to keep in touch with people who were important to them. Procedures were in place to take learning from any complaints or concerns and people were confident their shared lives carers and staff would take action to support them. Staff gave us examples of actions they had taken, including working with other health and social care professionals, so people’s decisions at the end of their lives would be met. The registered manager planned to further develop people’s care plans, so people’s wishes would be respected in the event of their sudden death.

Staff recognised people’s right to independence when considering their safety needs and developed care plans and risk assessments which supported people to do things they enjoyed safely. Shared lives carers and staff knew what action to take if they had any concerns for people’s well-being and safety and were confident senior staff would support people to be as safe as possible. People told us they had prompt assistance from their shared lives carers and staff when they wanted support. Some people enjoyed the independence of managing their own medicines. Where people needed assistance from shared lives carers to have the medicines they needed to remain well, people could rely on staff support shared lives carers who had been trained to do this safely.

People had developed close bonds with their shared lives carers. People and shared lives staff told us staff were kind and empathetic when supporting people. Shared lives carers and staff knew people well and spoke respectfully about them. People were assisted and supported to make their own decisions about their care. Shared lives carers and staff understood people’s rights to dignity, privacy and supported people to develop their independence.

People’s needs were carefully considered and assessed before they started to be supported by shared lives carers and staff, and care was planned which reflected people’s preferences and needs. Shared lives carers and staff had been provided with training and developed skills which were linked to the needs of the people they supported. Some people liked the independence of preparing their own drinks and food. Where people required specific support from shared lives carers to have enough to eat and drink assistance was provided, which reflected people’s preferences and so they would remain well. Staff and shared lives carers assisted people to see other health and social care professionals promptly, so they would enjoy the best health possible. 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 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.

Rating at last inspection

The last rating for this service was Good (published 25 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the requirement to display previous inspection ratings at this inspection. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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

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