Shared Lives South West

Shared Lives South West (referred to throughout the report as Shared Lives) is registered to provide personal care for adults who may have learning disabilities, mental health needs or physical disabilities, and for older people. Placements are made on a short or long-term basis, including respite and a holiday service, with people living with their carer in their home as part of the family. The service also supports parents with learning disabilities and provides a ‘home from hospital’ service. Shared Lives South West provides services across Devon and Cornwall and is a registered charity and a not for profit company.

Throughout the report the term carer(s) is used to identify the Shared Lives care workers as this is the term used by the service and familiar to the people being supported.

People’s experience of using this service:

• We found the service remained outstanding in the personalised support provided to people and carers. Without exception people told us they felt very much part of the family. They shared family celebrations and the family celebrated important events in their lives. One person told us, “We’re a family” and another said, “It’s fantastic.”

• People were safe and received the supported they needed to gain new skills and confidence to become more independent. Relatives told us they had complete faith and trust in the carers and Shared Lives staff. Their comments included, “I completely trust them”, and “From the word go, I was reassured that there was someone there to look after him.”

• People were fully involved in decisions about their care and support. The service regularly reviewed people’s needs to ensure these were fully understood and support plans reflected this. Where necessary health and social care professionals were involved in supporting people and their carers with guidance and advice about how to meet people’s support needs. The service was able to demonstrate the positive impact Shared Lives support has had on people.

• The service had a strong commitment to social inclusion. People told us of the support they received to improve their skills by going to college, developing hobbies and gaining employment.

• The service valued and respected people’s relationships with others.

• Carers described the service as excellent in the support it provided to them. The thorough assessment process and ongoing training ensured people were supported by carers who had the skills and knowledge to support them, as well as sharing their interests and hobbies. The ‘matching’ process ensured the success of placements.

• The service and carers had been recognised through various care agencies as being ‘exceptional’, having recently won three awards for the caring, compassionate and respectful support provided.

• The service was exceptionally well-led. The management team promoted shared decision making, with no one member of staff taking a decision alone which affected people and carers. Staff demonstrated a pride in working for the organisation: they were positive advocates for people and carers.

• The service used reflective practice to review how well people and carers were being supported and whether any more could be done. There was a commitment to continuous learning and improvement.

Rating at last inspection: the service was previously inspected in May and June 2016 and was rated good overall with the key question of ‘Is the service responsive?’ rated outstanding. The report was published on 6 August 2016.

Why we inspected: this announced inspection was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the information we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.

Shared Lives South West is registered to provide personal care for adults who may have learning disabilities, mental health needs or physical disabilities, and for older people. Placements are made on a short or longer term basis and the person lives with their carer in their home as part of the family. Shared Lives South West provides services across Devon and Cornwall and is a registered charity and a not for profit company.

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

Shared Lives South West’s mission statement was, “To deliver high quality Shared Lives and other related support services that focus on the sharing of home and family life and being an active member of the local community”. Throughout our inspection we found carers and staff promoted this and they held people’s welfare and happiness at the centre of everything they did.

The Shared Lives philosophy placed great emphasis on treating people as individuals and respecting their rights as citizens, while providing personalised support to improve people’s abilities, confidence and life experiences. The service supported people with varied and often very complex needs to live a safe and meaningful life in a caring family home environment. Without this support, many people would be unable to live alone as they would be at risk of social isolation, poor health, self-neglect, or abuse from others. The service was able to demonstrate how they had responded quickly and sensitively to prevent families being separated, children being taken into care or people being at risk from others due to their specific needs.

People and carers were ‘matched’ to ensure they shared similar interests and people’s needs could be supported in the carer’s home. People told us they valued their relationships with carers and they felt safe and well supported. People told us their lives had changed for the better since receiving support and the service was able to demonstrate very positive outcomes for people, particular some people with very complex needs or those who required an emergency place of safety. Staff and carers were proud of the support and care they provided to change people’s lives for the better. Carers were aware that some people could be at risk of harm or abuse from others or through their own behaviour and received training in safeguarding adults prior to commencing supporting people. They were aware of their responsibilities to notify the service and relevant authorities of any allegations of abuse or if people were placing themselves at risk because of their behaviour.

Thorough and safe processes were followed to recruit and assess carers and staff. An independent panel was involved in making the final decision about a carer’s suitability to join the service. Carers were given training and support to understand and meet the needs of the people they cared for, and had regular opportunities to meet their Shared Lives co-ordinator.

Each person was encouraged and supported to make choices and decisions about their care and how they wished to live their lives. The service had a positive approach to risk taking to enable people to experience new activities and environments to promote learning and development. Assessments ensured risks to people’s well-being and safety were identified and steps taken to reduce these. Where people did not have the mental capacity to make important decisions, the service worked with other professionals to ensure decisions made were in their best interests. People were encouraged and supported where necessary to attend GP and hospital appointments and to have regular health checks. Some people received support from special services, such as the community mental health or learning disability teams, or the probation service. This ensured carers had advice and support to help people remain healthy and safe.

People and their carers received regular visits from their named co-ordinator to check how the placement is progressing. They monitored people’s care and support needs and looked at people’s aims and ambitions to develop new skills and interest. Carers and people knew how to make a complaint and had no concerns about doing so: carers said the service listened to them. The co-ordinators told us they speak with people individually when they visited the person to gain their views about the support they received and whether they had any concerns. Where complaints had been received these had been recorded and investigated and the outcome identified any changes that needed to be made as a result.

Carers and staff were supported by being able to attend a number of meetings that allowed them to share any concerns they may have, to celebrate success and to discuss topics relating to people’s support needs, such as the principles of the Mental Capacity Act 2005.

The service was well managed and was continually looking to improve. Memberships of professional bodies, such as Shared Lives Plus, Skills for Care and Social Care Institute for Excellence, as well as subscriptions to professional journals, ensured the service kept up to date with current good practice. A process of self-assessment, internal reviews and audits allowed the registered manager to identify areas that were working well and those that could be improved. The registered manager told us how service was looking to expand in areas such as short breaks and emergency placements as well as supporting parents with young children. The service had recently been recognised for its work in supporting mothers with young children. They were aware of their responsibilities under the duty of candour, that is, their duty to be honest and open about any accident or incident that had caused or placed a person at risk of harm. Systems were in place for the reporting of notifications to CQC and incidents that involved people had been reported to us as required.

We saw there was a lengthy 'matching' process in place that ensured people were placed with carers that had the skills to meet their needs. There was evidence that people were consulted about their care and were involved in family life.

People living with carers told us that they were happy living there and were always asked what they wanted to do. When we visited people's homes we saw that there were good interactions between carers and the people who were living with them.

People who were living with carers told us they were aware of who they should speak with if they had any concerns. They also told us they had postcards they could send to Shared Lives to ask to speak with a Shared Lives Coordinator (SLC) in private. Carers told us that they had undertaken training about safeguarding issues and would report any concerns to the scheme immediately. All prospective carers attended safeguarding training before they were approved and had people live with them.

Shared Lives recruit SLCs and carers to work with people they support. We looked at the recruitment processes for both and found them to be robust. For example, we saw evidence that Disclosure and Barring Service (DBS) (criminal records) checks had been performed.

We found records to be well maintained and securely stored.

On the day of our visit the scheme supported 261 people who lived with 241 carers.

We spoke with four people who lived with carers and three carers who provided the support. They told us that they were regularly asked for their views about the services provided. One person that we spoke with told us their carer was "a very nice woman, never known anyone like her" and "If I didn't like it I wouldn't be living here".

The files of three individual's who lived with carers were inspected. Comprehensive provider placement agreements were seen which clearly set out what the individual and the scheme expected from the carer and what the carer could expect from the scheme in return.

We saw that people were involved in the planning and review of their support. People were given opportunities to express their wishes and preferences and we saw that this was an important element in structuring how their care and support was provided.

The manager of the scheme told us how the scheme intended to involve people, who lived with carers, more. They said that their aim was that people would be "active participants in the organisation". People who lived with carers were being supported to design 'user friendly' information for other people who lived with carers.