Archived: Guideposts Trust Limited Shared LIves Scheme

Guideposts Trust Limited provides a ‘shared lives’ service for adults who need support and who want to live as part of a family or household. It is an alternative to residential care for people and provides a flexible form of accommodation, care or support inside or outside the Shared lives carer’s home. It provides services for people with learning, physical or sensory disabilities and people with mental health problems. The service provides long term placements, short term placements and respite care. It is responsible for co-ordination between the people who use the service and the carers with whom people live.

For the purposes of this report we will refer to those who provide support as ‘carers’. At the time of our inspection the service was providing support to 43 people, however just 34 people received ‘personal care’ support regulated by the Care Quality Commission.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

During our inspection we looked at how the service managed the recruitment of carers to support people, how they matched people needing support to the carer who supported them. We also looked at how the service ensured the carers were trained and how they reviewed the care and support people received to ensure their needs were fully met.

There was a close collaboration with social workers and health professionals who were involved in the oversight of the processes and care management of the people who used the service. The staff directly employed to work in the provider`s office were responsible for recruiting carers who provided the care and support that people needed within their own families or households. Carers were self-employed and contracted to collaborate with the provider and signed a contract when they agreed to sign up to the shared life scheme.

People were safe and the carers we spoke with were knowledgeable about safeguarding procedures and how to keep people safe from the risk of abuse. The provider had processes in place to identify and manage risks, however not all identified risks had risks management plans developed in people`s care plans.

People received care from carers who knew them well and were able to meet their needs in a family like environment. We found that the training carers received was comprehensive when they first started their collaboration with the service; however refresher training was not always done in a timely manner. The provider had identified this and they scheduled the training staff required. Carers understood the need to obtain consent from people when providing care and support. People who were not able to communicate their decisions received care and support which was agreed by health and social care professionals to be in their best interest.

People were supported with meals and to make choices about the food and drink they received. Carers supported people to maintain good health and access health services when needed.

When people started using the service comprehensive assessments were carried out which looked at their identified care and support needs but also at the environment they were moving to. Personalised care plans were in place which reflected individual needs and preferences, however these were not always updated to reflect people`s changing needs or the current support they received.

The staff employed at the office carried out quarterly visits to each person and their carers to carry out health and safety checks, supervision with carers and to check if the care and support people received was safe and met their needs. These meetings were recorded and clearly documented any issues if found, or people`s changing needs, however this had not triggered a care plan update or changes to the plans of support people received.

The provider had recently changed the governance systems they used to monitor the quality and the effectiveness of the service. The new systems were very new and not entirely efficient or consistent. However the registered manager had identified this and they were constantly monitoring and improving the systems used.

The provider had recognised that the carers who opened their family home and cared for and supported a person as part of their family, often for years, needed a support network around them to help them cope with all aspects of the job. They were developing regular carers’ meetings and an on-line support network where carers could communicate and support each other by sharing their experiences.

People told us that they received the support that they wanted and needed. They said they were involved in decision making every step of the way. Professionals with whom we spoke told us that the service continued to work with the best interests of the people who used the service at the heart of everything they did.

All people with whom we spoke told us they would be, '"Totally comfortable" to approach the management team if they had any concerns over the service provided. They said that they were confident that the management team would listen to their concerns and deal with them appropriately and in a timely manner.

Information was made available to people about the service. Documentation used in people's care plans was accessible because it was pictorial and in an easy read format.

People's needs were assessed and care and treatment was planned and delivered in accordance with that assessment. People spoke very highly of the service. One relative said, 'Guideposts Trust is a fabulous set up for us, I have visited [other services] and they would not be able to provide us with what Guideposts are able to provide.'

People were protected from the risk of abuse because the provider had clear safeguarding procedures which were understood by those who looked after people they lived with.

Carers were supported to carry out their role because their skills were matched to the needs of the people using the service and they were given appropriate opportunities for training and development.

People were asked for their views on the service by way of an annual questionnaire. The quality of service was monitored through regular contact with the scheme's support staff. Complaints and compliments were used to take action to improve the service.