Shared Lives Scheme (West Sussex County Council)

Shared Lives Scheme (West Sussex County Council) is registered to provide personal care and support. The service offers long term and short-term placements for adults and older people living in the West Sussex area, who have a learning disability. People who have a mental health need are also supported when there is a dual diagnosis of a learning disability. People may also have a physical and/or sensory disability. People had access to ‘day share’ facility, where they could go to a shared lives carer for the day. 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 (SLCs) and people they care for are matched for compatibility 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. Not all provided the regulated activity of personal care at the time of the inspection, but may be supporting people with developing access into their local neighbourhood and helping develop people's life skills towards improved independence.

Shared lives carers are supported and managed by staff employed at Shared Lives West Sussex County Council. The provider is responsible for ensuring SLCs are provided with the appropriate knowledge, skills and support to undertake this role. The provider employs Shared Lives Officers (SLOs) to carry out this role. The service operates throughout West Sussex and at the time of inspection provided care and or support to 144 clients from 96 households.

Following the last inspection on 26 June 2017, the service was rated as Required Improvement. At the current inspection, we found that sufficient improvements had been made in the areas of safe and well-led that the services overall rating had improved to Good.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

Shared lives staff and shared lives carers showed a genuine and in-depth understanding and compassion for the people they supported. People were treated with high standards of kindness, compassion and respect. Their independence was promoted as far as possible, whilst respecting their choices. There was a very strong emphasis on people having choices and their preferences being respected. People were actively involved in their support and in the recruitment process of other shared lives carers.

Risks to people's personal safety and wellbeing had been assessed and plans were in place to minimise these risks. People were protected against abuse and avoidable harm. People involved in accidents and incidents were supported to stay safe and action was taken to prevent further injury or harm. People’s medicines were safely managed.

Assessments were holistic and took account of people’s diverse and complex needs. People and relatives took part in the interview process for new staff and had an influence over who was recruited. The registered manager ensured there were enough qualified, skilled and knowledgeable staff to meet people's needs. Shared lives staff and carers received training that was bespoke to shared lives arrangements and needs.

Carers were aware of people's individual preferences and patterns of eating and drinking and people were encouraged to improve their life skills and to be involved in the preparation of meals in the shared lives households.

Shared lives staff and shared lives carers worked well together, and with other professionals, to ensure people received effective care and support. Staff followed the requirements of the Mental Capacity Act 2005, only providing care with people's consent. Where they had concerns about someone's ability to give consent to aspects of their care, best interests decisions were recorded so the person's needs were met in the least restrictive way possible.

Care and support was tailored to people's individual needs. People were encouraged and supported to be involved in the care planning and review process. Arrangements for social activities met people's individual needs; there was an emphasis on people living as full a life as possible. Shared lives carers went to great lengths to arrange activities that people really wanted to take part in, based on their interests or expressed wishes.

Complaints procedures were in place and available in formats to support people to raises issues should they need to. The provider used learning from complaints to drive improvements in the service.

People, their relatives, shared lives workers and shared lives carers all spoke positively about the support and management skills of the leadership team. They told us that managers and senior staff were approachable, open and very supportive. The registered manager had a clear vision of the direction of the service and had ensured that a robust and clear quality assurance system was in place. People, their relatives and staff were engaged and involved in the service and the provider worked closely with professionals and agencies to ensure effective support was delivered.

Shared Lives Scheme (West Sussex County Council) is registered to provide personal care and support. The service offers long term and short term placements for adults and older people living in the West Sussex area, who have a learning disability, are autistic or a mental health need. People may also have a physical or sensory disability. A ‘day share’ facility where people can go to a shared lives carer for the day is also available to access. 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 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 180 people were supported by 80 registered shared lives carers in the scheme. Not all provided the regulated activity of personal care at the time of the inspection, but may be supporting people with developing access into their local neighbourhood and helping develop people’s life skills towards improved independence. Shared lives carers are supported and managed by staff employed by the service.

The last inspection was on 3 August 2014 where no concerns were raised. The service was rated good overall. However, at this inspection there were some shortfalls identified. This was in relation to the completion of paperwork for example, risk assessments to ensure all risks were fully identified and managed for the continued safety of people. The auditing of the service to identify any shortfalls and to ensure feedback received was used to inform the drive for further improvements in the service. We did not find this had impacted on the safety of people but were areas in need of improvement.

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 for the service with identified leadership roles. The registered manager was supported by two senior shared lives workers and seven shared lives workers.

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. When asked what the service did well comments received from staff included, “The service is extremely person centred. We support the carers and the customers well. Matching the customer to the carers and the household is really important and makes the difference,” “We are a good model for person centred care. It’s about listening to people, listening to carers to change their approach and ensuring people receive the care they need,” and “We are very, very person centred. We deliver good training and get good feedback.” Individual risk assessments were in place to ensure people were safe within their own home and when they received care and support and undertook activities.

People told us they felt safe in the service. One person told us, “Safe I sure am, I trust my carers”. Another person told us, “Always someone in the house. That’s why we keep safe.” A third person said, “Safe, yeah (Shared lives carers name) looks after me very, very well it's a lovely home and it's nice to have. I was moved here for three months I've been her five I hope I can stay longer.” People were supported by shared lives workers 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. 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. Staff 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. Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

New shared lives workers went through a robust recruitment process. New shared lives carers underwent rigorous assessment and checks before being ‘matched’ with people who needed support. Applications for new shared lives carers went to the local ‘Shared Lives panel’ which was part of the assessment process. People told us how they liked their accommodation and enjoyed living with their shared lives carers. Their cultural needs were taken into account when they were matched with potential carers. They felt able to express their views and were involved in decisions affecting them. People had contact with their relatives and were supported to stay in touch.

People were supported by kind caring staff. Shared lives workers and carers were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. One shared lives worker told us how they were being supported to complete a social work qualification. One shared lives carer told us “We do more training than ever. They have added in dementia, which is a good idea as people get older. It’s all about safety, fire, health and hygiene, food, safeguarding. So it’s important and there’s a steady availability of training. They want to check our certificates when they visit, along with our paperwork, finance, care, medicines, house insurance, risk assessments. Separate from that, two people come to do health and safety checks and food hygiene checks.”

They told us that communication throughout the service was good. 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, “We are supported when we need it 100%. In the past we got on with things on our own but now we use the scheme more. Our support worker (Shared lives worker’s name) has been with us three years, she has built a really good relationship with us and the men we look after. She comes every two months, but she’d come at once if we need her. She checks how everything is going, care and admin.” Another shared lives carer told us, “There are carers’ meetings. They dot them around the county, but they realise attendance will be difficult for some people. Changes and information get shared there, but we all have a folder of policies and they email any updates. I know the manager and all staff very well. We often get emails asking for views on different aspects of the scheme. At Christmas we were asked for our best memories of working with people in the scheme, which gave some great positives to share.” Another shared lives carer said they had regular visits from their shared lives worker, “She spends a lot of time on policies and procedures when she comes out. Always checks files and risk assessments are up to date. Next visit date is always set before she leaves. It’s always six weeks but is fitted with my other work commitments. She always spends time with (Person’s name) and liaises with social services about his ski holiday. She makes sure I’m aware of training requirements and helps me with on-line booking.”

People were supported access a range of activities. One shared lives carer told us the person they supported was, “Very much part of the family. Also goes on two holidays a year and has a full social life here.” People were encouraged to develop their independent in relation to life skills. One shared lives carer told us about one person who was living with them, “We are getting used to each other now. We visited her at her previous placement and she stayed a trial week with us. At first she couldn’t be left alone. Care plan now agrees up to four hours alone, but haven’t yet extended beyond one hour. She loves family environment, and working on independence skills. She has started to show skills in the kitchen, which is a new development. One day a week she is home all day, does washing etc. and likes to do art work, go for walks with family dog. Also we have always arranged medical and other appointments for that regular day.” Another shared lives carer told us the person they supported undertook some everyday tasks and had part time sheltered job. They could not socialise or be left alone but can be left in familiar company i.e. work, swimming club, drama club. They saw it as important to provide outlets for independence from total dependence in the placement. They told us the person had learnt to do more towards their personal care.

There was a detailed complaints procedure. People knew who to talk to if they had any concerns. The registered manager told us that they operated an 'open door policy' so people, their rep

People said that they found the Shared Lives carers to be 'lovely, very kind, caring and professional". Shared Lives carers had a good awareness of the importance of keeping people safe and they understood their responsibilities for reporting any concerns regarding abuse. West Sussex Shared Lives enabled people who used the service to live as part of a family; people who used the service were supported to make informed decisions where the person was unable to do this by themselves.

The people we spoke with told us they were happy with the care that they had received and with the staff team. A person who used the service told us 'Yeah all fine, no problems at all, I'm happy'. Another person who used the service we spoke with told us 'I'm thrilled with it all, yes I'm very happy'. Staff we spoke with had a good understanding of the support needs of the people who used the service. One member of staff told us 'We help to promote choice for people and provide them with good support'.

During our visit, staff we spoke with confirmed that they had felt supported and had received relevant training, which had included the safeguarding of vulnerable adults. We saw that the service had ensured that Shared Lives Carers were able to deliver care and treatment safely through regular training and assessments. 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.