Shared Lives Service

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

The service provides long term placements, short breaks, respite care, day care and emergency care for adults with a range of needs, within carers’ own homes. Carers are recruited, assessed and supported to carry out this provision of care. People have the opportunity to live in an ordinary home as part of the carer’s family. Respite care is provided to people living with their own family and also to people living within a shared lives placement. The service operates throughout Lancashire and is the largest Shared Lives provider in the Country, supporting 11% of the Adult Learning Disability population within the Lancashire Local Authority boundary. A total of 371 people were being supported within 287 households at the time of our inspection. 227 of those were being supported on a long term basis.

The service had an established registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

All of the people we spoke with who used the service told us they felt safe.

We spoke with staff and carers about the service’s safeguarding procedures. They were all aware of the provider’s safeguarding policy and how to report any potential allegations of abuse or concerns raised and were aware of the procedures to follow.

We looked at recruitment processes and found the service had recruitment policies and procedures in place to help ensure safety in the recruitment of staff. Prospective employees were asked to undertake checks prior to employment to help ensure they were not a risk to vulnerable people.

We looked at the systems for medicines management. We saw clear audits were regularly conducted via submission of people’s Medication Administration Records (MARs) and detailed policies and procedures were in place. Carers told us that they received adequate training in relation to administering people’s medicines and when we visited people, we looked at the systems they had in place.

People who used the service and their carers told us they were supported by staff members who had the appropriate skills and knowledge. We received very positive comments regarding the Shared Lives team.

When we visited people in their Shared Lives home it was apparent that they felt comfortable in this environment and with the people caring for them. The people we saw were affectionate towards their carers and we were told by people and carers alike that they were a ‘family’.

We spoke with staff in relation to the training they undertook. All the staff we spoke with talked very positively of the training they had and said they felt confident that they received the appropriate level of training and support they needed to do their job effectively. We saw evidence that training directly impacted the quality of the service people received and that staff and Shared Lives carers continually developed and benefitted from a structured and tailored training programme that evolved.

We spoke with people who used the service to see if they felt they were supported by staff who were caring and compassionate and to see if they were happy with their Shared Lives home and carers. The responses we received were unanimously positive in this area.

A detailed matching process was in place that meant people were matched with Shared Lives carers who shared similar interests, personalities and interests in life. This process was sen to be very thorough and appropriate given the vulnerability of some of the people being placed.

The impact of the service on people’s lives, in most cases in a short space of time, showed that the ethos of the service was working well. People, by becoming part of a ‘family,’ were receiving support and growing in confidence which was positively changing their lives. From speaking with people we saw and heard at first hand real stories and examples of people who had entered the service with health, emotional and social problems who had begun to address and overcome them with the support of a 'family' and the Shared Lives service.

People’s religious beliefs and wishes were supported and this was documented within people’s support plans. We found from observations and discussions with people, carers and staff that there was a culture of respect throughout the service which benefitted everyone involved.

We saw that the service had a detailed complaint policy in place. We saw there were a low level of complaints and that they were dealt with effectively. A large number of formal compliments had been received which reflected the discussions and evidence we found.

We received very positive comments about the registered manager from all the people we spoke with. People knew who they were and what their role was and told us they were approachable, knowledgeable and cared about their role and the people who received a service.

There were a number of mechanisms in place for people living within the Shared Lives settings and their carers to meet up with their peers. People told us that they met up for dinner and other activities across different parts of the County, so there was no disparity from area to area in terms of giving people the opportunity to network and meet other people with similar experiences to them. This meant that an additional layer of informal support was made available to people and carers which they told us was invaluable to them.

We saw evidence that staff meetings were held and staff we spoke with confirmed this to be the case. Staff told us they found staff meetings useful and that they had the opportunity to contribute within that forum.