Certitude London Shared Lives

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people continue to be safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The scheme had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People placed by the scheme and the carers themselves were encouraged and supported to raise safety concerns with their allocated coordinators and the schemes management. The scheme understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when these arose. Managers investigated safety concerns and events and used the learning from these to support coordinators and carers to continually improve their practice, reduce risk and keep people safe. An external care professional told us, “The scheme promotes an open and learning culture and this permeates through their regular contract monitoring meetings with us. Where there have been incidents and/or complaints, they have protocols in place and respond appropriately.”

The registered manager understood their responsibilities under duty of candour and the need to apologise when things went wrong. They told us, “We always acknowledge when things go wrong or we could have done better, so we’re continuously learning lessons and trying to improve.”

The scheme always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well-managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

Information was obtained from people, and others involved in their care, about people’s individual needs and risks to their safety at the initial referral stage. People were fully consulted when moving into a new placement. For example, we saw people's potential worries were recorded and how these could be managed. It also included pictures and details of the new placement and the type of person and family who would be a suitable placement match. This information was then used to develop individualised support plans to ensure people received safe and appropriate care from the moment they went to live with their carer. A carer told us, “The scheme operates an excellent matching process. They take everyone’s needs and wishes into account. It’s so important to get the process right and in my experience Certitude do get this right. All the placements I’ve had have been an enormous success.”

The scheme worked closely with the relevant funding local authority to ensure people received continuity of care when peoples personal circumstances changed and placements were no longer suitable. For example, after a carers personal circumstances had changed and they were no longer able to support a person placed with them, the former carers next of kin took over the placement. This suited all the interested parties and ensured the person received continuity of care from a carer they knew well and had previously lived with.

The scheme worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

The scheme understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A carer told us, “I’ve received my safeguarding training which the scheme regular refreshes. I know I can contact my coordinator or any of the managers in the office if im ever worried that a person who lives with me might be being abused or neglected.” People told us they felt safe living with their carers. An external care professional remarked, “We believe our clients are safe in their shared lives placements. The shared lives carers provide a safe, stable, and welcoming environment for everyone they support.” Another added, “We feel that safety is one of the service’s strong points because they offer carers a good training package, and have systems and processes in place to report and respond to issues and safety concerns.”

Managers worked proactively with the relevant external health and social agencies when a concern was raised, and took appropriate action to safeguard people from further risk, when this was required. The registered manager gave us an example of appropriate action they had taken to immediately rehome a person with a respite carer as a temporary interim measure while a safeguarding incident in relation to a carer was investigated.

The scheme worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The scheme ensured potential risks people might face were mitigated. Coordinators and carers were aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. An external care professional told us, “The scheme understands the potential risks our clients might encounter. We hold regular monthly meetings where we openly discuss safeguarding concerns, risk management and individual support plans for our clients. This means everyone involved is well-informed about what to look out for and how to address any emerging issues quickly.”

People’s care records contained up to date, sufficiently detailed and accurate information. Carers told us they always followed people’s risk assessments to enable people to take reasonable and acceptable risks. For example, we saw areas of potential risk in various areas such as maintaining a healthy lifestyle, travelling independently in the local community and self-medicating. Each identified area included the reasons why it was relevant, what the actual risk was, what needed to be done to keep the person safe and what to do if things went wrong. Systems were in place to ensure risks to people were continually assessed, monitored and reviewed.

The scheme detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The scheme ensured potential risks in a carers homes were always assessed and controlled, including any equipment used. Environmental health and safety risk assessments on prospective carers homes had to be conducted by the scheme as part of the initial approval process. Coordinators regularly checked the health and safety of the homes where people shared their lives with their carers.

There was clear guidance and training available to carers to enable them to safely deal with emergencies including, personal emergency evacuation plans [PEEPs] for everyone placed by the scheme. Carers were aware of these PEEPs and their fire safety roles and responsibilities. An external care professional told us, “The service ensures people live in a safe and supportive environment which gives peace of mind to families and other professionals.”

The scheme made sure there were enough qualified, skilled and experienced staff coordinators, who received effective support, supervision and development however, some shared lives carers had not kept all their mandatory training up to date. They shared lives carers and staff coordinators worked together well to provide safe care that met people’s individual needs.

The training of new coordinators and carers included a comprehensive induction programme, which was mapped to the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in health and social care sectors. Coordinators and carers received a mixture of e-learning and in-person practical and theoretical training and had all received their initial mandatory training. An external care professional told us, “I believe the Shared Lives coordinators and carers are all competent and capable.” The registered manager told us induction training had to be successfully completed before a carer could be presented to the schemes approval panel who interviewed, vetted and officially approved any new carers as suitably fit and proper. Carers told us they had received all the relevant training they required to meet the needs of the people placed with them.

However, a third of carers mandatory training had not been routinely refreshed, contrary to the schemes training policies and procedures. The provider was aware of this training issue as the shortfall had been identified during a recent internal audit. The registered manager told us a time specific action plan had been developed to address this gap in carers training within the next 3 to 6 months.

People placed by the scheme and carers were supported by their allocated coordinators who were responsible for overseeing a number of shared lives placements. The coordinators in turn were supported by the schemes registered manager. Carers had ongoing opportunities to reflect on their role and to identify any further training, learning or support needs they had with their allocated coordinator who they were in regular face-to-face, telephone and email contact with. Coordinators had regular opportunities to meet individually or as a group with their coworkers and the services registered manager.

The schemes staff and carers recruitment processes were thorough, and records demonstrated that they were followed. The provider conducted thorough pre-employment checks to ensure the suitability of all their staff and the carers. These included checks on their identity, previous employment, character and the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer.

In addition, carers who were all self-employed, had to be formally approved by the scheme before they could start having people placed with them in their family home. The process included a number of visits to potential care' homes, risk assessments and vetting by the schemes approval panel which comprised of shared lives staff, independent health and social care professionals and experienced shared lives carers.

The scheme assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Carers and coordinators received infection control and food hygiene training. Carers had ample supplies of personal protective equipment which was routinely delivered to the carers home. The schemes infection prevention and control policies and procedures reflected national guidance.

The scheme made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should. Care plans included detailed guidance about how people preferred their medicines to be administered. Coordinators and carers received relevant medicines training and their competency to continue managing medicines safely was routinely assessed. This meant they were clear about their roles and responsibilities in relation to the safe management and administration of medicines. There were regular audits of medicines carers administered on behalf of the people they shared their lives with. This included regular quality monitoring checks conducted by the coordinator on carers medicines handling practices. The scheme had policies in place relating to safe management of medicines.

People assessed as willing and capable of managing their prescribed medicines safely were actively encouraged and supported by the scheme to do so.