Archived: North West Shared Lives

People’s experience of using this service: We tried to make contact with the provider on a number of occasions by email, telephone, text message and by post. We visited the premises registered to CQC on the first date of the inspection and we were able to conclude that the service was not operating from this address. We then visited the providers address but there was no one in. We telephoned, emailed and left a message through the door but still received no response.

We managed to make contact with some of the staff who were supporting people using the service to live in their homes. We were able to establish that the service was still operating and people were still using it.

We informed the local authority of our concerns and asked them to check that the people receiving care from the service were safe.

Rating at last inspection: The service was rated Requires Improvement at the last inspection in November 2016.

Why we inspected: We tried to inspect to follow up concerns about the service identified at our previous inspection.

Enforcement: We are considering enforcement action and will report on this if and when it is completed.

Follow up: We will continue to try and make contact with the provider and will liaise with the local authority to check that people using the service are safe.

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

North West Shared Lives registered with the Care Quality Commission (CQC) in May 2013 and this was the service’s first inspection.

At the time of our inspection, 10 people were supported in the homes of eight shared lives carers in and around the Liverpool area. ‘Shared lives’ describes an arrangement whereby people either live with or near to self-employed shared lives carers who support them to meet their assessed needs.

The North West Shared Lives team consisted of the registered manager who was also the nominated individual, and a director. A registered manager is a person who has registered with 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 2008 and associated Regulations about how the service is run. A nominated individual is a person appointed to supervise the management of the carrying on of the regulated activity.

The registered provider had changed their address in January 2016 and submitted an incomplete application to change the location address, which was rejected. As a result, we found the location address was not correct at the time of this inspection in November 2016.

The registered manager did not ensure shared lives carers kept medicines administration records. She therefore did not monitor whether people received their medicines safely and as prescribed.

A full and robust recruitment procedure was not followed when the shared lives carers transferred from an existing scheme to North West Shared Lives in 2013. This was because the registered manager and director had each known the carers and the people placed with them for many years.

North West Shared Lives did not provide training for the shared lives carers or make a regular assessment of carers’ competence to support the people placed with them. The registered manager said most people had been in their placements for well over 10 years and were considered part of their shared lives carers’ family.

Shared lives carers we spoke with had limited knowledge and understanding of the Mental Capacity Act 2005. People’s risk assessments and support plans showed decisions had not been made in line with the legislation.

Most people had person-centred risk assessments which aimed to mitigate or reduce the risks they faced in everyday life. Shared lives carers could describe how the people they supported might be vulnerable. We found one person did not have risk assessments for the use of a hoist.

We recommended the registered manager seek advice and support about the role and responsibility of registered managers in shared lives schemes.

We found issues with the registered manager’s oversight of the service, in terms of audit and monitoring.

Shared lives carers and the registered manager had a good knowledge of safeguarding and knew how to report any concerns appropriately.

People were positive about the meals they had in their shared lives placements. Some said they helped to shop for food and cook meals with their shared lives carers. Shared lives carers tried to support people to make healthy food choices.

People’s shared lives carers supported them to maintain their holistic health by managing appointments with other healthcare professionals. These included GPs, diabetic nurses and dentists.

People told us their shared lives carers were kind, and respected their privacy and independence. Those we spoke with said they were very happy in their placement homes.

The shared lives carers we spoke with said the people they supported were considered part of their families.

People were supported to access advocacy services when they needed help to make decisions.

The shared lives carers could access people’s risk assessments and support plans via a secure internet ‘cloud’. We saw documents in the office were stored securely.

People’s support plans contained sufficient detail and were person-centred. People we spoke with told us their shared lives carers provided the support they needed. The registered manager was in the process of advance planning for people’s future needs when either they or their shared lives carers became older people.

People had active social lives and opportunities to take part in activities, to work and to develop their academic skills. Shared lives carers supported people to go on holidays with them and people told us they really enjoyed them.

No one we spoke with had made a formal complaint to North West Shared Lives, either about a shared lives carer or the service itself. The service had a complaints process and guidance was available in an easy to read format.

Feedback about the registered manager and director was positive. People and shared lives carers gave us examples of when the registered manager had been extremely supportive.

People and their shared lives carers were asked to feedback about the service. The registered manager organised meetings for the shared lives carers to discuss issues and share experiences.

The registered manager and director worked in partnership with other healthcare professionals and agencies to meet people’s needs. They and the shared lives carers they oversaw demonstrated the vision and values of the service in the care they provided to the people the scheme supported.

We found breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. You can see what action we have told the provider to take at the back of the full version of the report.