Shared Lives Service

Updated 4 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of three adult social care inspectors, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had experience of caring for people with learning disabilities and older people.

Service and service type:

The service is a shared lives service which provides long term placements, short breaks, respite care, day care and emergency care for adults with a range of needs, within carers' own homes.

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 visit because it is extremely large and we needed to make arrangements to speak to people in their own homes and in the office.

What we did:

Before our inspection, we reviewed all the information we held about the service and completed our planning tool. We also checked for feedback we received from members of the public, local authorities, Healthwatch, safeguarding and clinical commissioning groups. We also checked records held by Companies House.

We asked the service to complete a 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. We reviewed this information and used it to inform our planning tool.

During inspection we spoke with 26 people who used the service, 19 carers and two relatives to ask about their experience of the care provided. We also spoke with the registered manager, two support officers and three support staff.

We reviewed a range of records. This included, four people's care records and two staff files around recruitment. We also looked at various records in relation to medication, training and supervision of staff, records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider.

Shortly after our inspection, we contacted external professionals to ask them for feedback on their experiences of the service. Their feedback was overwhelmingly positive.

Updated 4 May 2019

About the service: Shared Lives Service is a shared lives service that recruits, trains and

supports self-employed shared lives carers (carers) who offer accommodation and support arrangements for vulnerable adults within their own family homes in the community. The service is registered to support people with a variety of needs including people with learning disabilities.

CQC only inspects the service being received by people provided with 'personal care'. This includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At this inspection there were 369 people using the service and in receipt of a regulated activity.

People’s experience of using this service: We saw excellent examples of how people were supported to remain safe at times when they were at significant risk. Through robust safeguarding training, staff and carers were able to keep people safe at times when their lives were in crisis. Staff and carers were proactive and supported people to take positive risks, ensuring they had maximum choice and control of their lives.

The provider‘s robust recruitment processes for staff and carers, along with the matching process, had exceptionally positive outcomes for people. Medicines were managed safely and people were supported to be as independent as possible with their medicines. There was an open and transparent culture in relation to accidents and incidents and they were used as opportunities to learn and lessen risks.

People’s needs were met through robust assessments and support planning. We saw outstanding examples of when the service had worked with other healthcare professionals to achieve positive outcomes for people and to improve their quality of life. Staff and carers had excellent knowledge and skills and the training made available to them ensured people’s needs were extremely well met.

We saw outstanding examples of when people had been supported to maintain a healthy and balanced diet and how this had significantly improved their lives. People with complex health needs received care and support that was positive and consistent and which improved their quality of life. The provider’s policies and systems ensured people were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.

People unanimously told us carers and staff were exceptionally compassionate and kind. Staff and carers expressed commitment to ensuring people received high-quality care. We saw excellent examples of how carers ensured people felt part of their family. Carers and staff knew people exceptionally well and supported them to maintain relationships with people that mattered to them. For those people with protected characteristics as defined in the Equality Act, we saw excellent examples of how the service, staff and carers were proactive in how they supported them. People were encouraged to learn new skills to enhance their independence and were treated with the utmost dignity and respect.

People received care and support that was evidently person-centred. We received overwhelming feedback of the positive impact this had on people and how they had changed people’s lives. We saw excellent examples of how the care and support people received enriched their lives through meaningful activities. The service was proactive in its response to concerns or complaints and people knew how to feedback their experiences.

The registered manager planned and promoted holistic, person-centred, high-quality care resulting in excellent outcomes for people. The values and culture embedded in the service ensured people were at the heart of the care and support they received. Carers and staff told us they received excellent support from management and staff told us they were extremely proud to work for the service. There was a very open and transparent culture and people were empowered to voice their opinions. Without exception, people told us the service was well-managed.

Rating at last inspection: Outstanding (07 September 2016)

Why we inspected: We carried out this inspection based on the previous rating of the service.

Follow up: We will continue to review information we receive about the service until we return to visit as part of our re-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