Archived: Surrey Shared Lives Scheme

Surrey Shared Lives Scheme arranges accommodation and personal care placements for adults with learning disabilities. The scheme is responsible for supporting and monitoring Shared Lives placements and recruiting Shared Lives carers.

A Shared Lives carer is a person who provides personal care together with accommodation in their own home. They work within the carer’s agreement and Shared Lives agreement to meet the needs of the people they support. They are recruited, trained, approved and monitored by Shared Lives schemes but are self-employed. No more than three people normally live with a Shared Lives carer at any one time. There were 18 people receiving support at the time of our inspection.

There was a registered manager in place at the time of our inspection. Like registered providers, registered managers 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.

The provider’s Area Operations Manager held the role of registered manager at the time of our inspection. The Area Operations Manager told us they had registered for the role as the scheme had been without a permanent manager in the past and it was a condition of the scheme’s registration that a registered manager was in place. The Area Operations Manager said the scheme manager would apply for registration in the near future.

People were protected by the provider’s procedures for the recruitment and approval of Shared Lives carers. Following the completion of recruitment checks, a home visit and interview was carried out by the scheme manager to assess the applicant’s suitability for the role. Once a Shared Lives carer had been confirmed as suitable by the scheme manager, they were subject to an assessment by a panel comprised of people with relevant experience but who were independent of the scheme.

People were kept safe because Shared Lives carers knew how to recognise and report abuse. Shared Lives carers had attended training in safeguarding and were clear about their responsibilities to report any concerns they had about abuse or people’s safety.

Shared Lives carers recorded any accidents and incidents and informed the scheme manager of these. Where an incident or accident had occurred, there was a clear record of how the event had occurred and what action could be taken to be taken to prevent a recurrence. Where people’s care involved support with medicines, this was managed safely.

Risk assessments had been carried out to ensure that the environment in which people lived was safe. The scheme manager had also carried out individual risk assessments relevant to each person to support them to stay safe. The provider had developed a business continuity plan for the service, which meant people would continue to receive support in the event of an emergency.

Each placement was regularly reviewed to ensure it continued to meet the needs of the person receiving support. Shared Lives carers were subject to a process of re-approval by a panel every three years and reviewed by the scheme manager annually. The scheme manager was able to request a panel review at any time should this be required. Panels had the ability to impose sanctions if Shared Lives carers did not comply with the shared lives agreement and we saw evidence that sanctions had been imposed where appropriate.

Shared Lives carers had access to the training they needed to perform their roles effectively including any specific training required to meet the needs of the people they supported.

People’s care and support was provided in accordance with the Mental Capacity Act 2005. Shared Lives carers had received training on the principles of the Act and how these principles applied in their work. Assessments had been carried out where necessary to establish whether people had the capacity to make decisions about their care and support.

Where people lacked the capacity to make decisions for themselves, the scheme manager had arranged meetings to ensure that decisions were made in people’s best interests. Applications for DoLS authorisations had been made where restrictions were imposed upon people to keep them safe.

People enjoyed the food provided at their placements and were involved in choosing the food they ate. They said they enjoyed eating out and often did this with their Shared Lives carers. Shared Lives carers told us they aimed to provide food people enjoyed whilst promoting a balanced diet.

People’s healthcare needs were monitored effectively. Shared Lives carers supported people to make a medical appointment if they felt unwell and accompanied them to all appointments.

Shared Lives carers recorded the outcomes of healthcare appointments and the scheme manager checked these records at regular monitoring visits.

People had developed positive, lasting relationships with their Shared Lives carers and enjoyed their company. They told us they valued the family atmosphere of their placements and were included in the family lives of their Shared Lives carers.

People told us their Shared Lives carers were kind and caring and treated them with respect. They said could spend time on their own whenever they wished and that their privacy was respected. Shared Lives carers spoke with genuine affection about the people that shared their home. All the Shared Lives carers we spoke with were committed to creating an environment in which the person receiving support felt part of their family.

People were supported in a way that promoted their independence. They were encouraged to do things for themselves where possible and given support to develop new skills.

People had access to information about their care and support. There was a written agreement in place for each placement which set out the rights and responsibilities of all parties. People’s private and confidential information was managed appropriately.

People received support that was responsive to their individual needs. Each person’s needs had been assessed before they moved in with a Shared Lives carer to ensure the placement could provide the support they needed.

Each person had an individual care plan drawn up from their initial assessment. People told us they had been encouraged to contribute to this process and confirmed their care plans reflected their preferences about the support they received.

People told us their Shared Lives carers supported them to take part in activities that were important to them. They said they had opportunities to enjoy an active social life and to maintain contact with their friends and families.

The provider had a written complaints procedure, which detailed how complaints would be managed. None of the people we spoke with had made a complaint but all said they would feel comfortable raising concerns if necessary.

The scheme manager provided effective support to Shared Lives carers. Shared Lives carers told us the scheme manager was supportive and had worked closely with them to identify solutions if challenges had occurred. They said the expectations of them in their role were clear and the scheme manager had created an environment in which they felt comfortable raising any difficulties they experienced.

There were effective systems in place to monitor the quality of support people received. The scheme manager visited each placement regularly to meet with people receiving support and Shared Lives carers to seek their views. People and their Shared Lives carers also had opportunities to give their views about the support they received through satisfaction surveys, which the provider distributed and collated annually.

The records we checked in the agency’s office were accurate, up to date and stored appropriately. Shared Lives carers maintained comprehensive records for each person, which were audited regularly by the scheme manager. The scheme manager was aware of their responsibilities under the Health and Social Care Act 2008 and had ensured that any notifiable incidents were reported to the CQC.

We last inspected this service on 20 December 2013 when no concerns were identified.

Two people who used this service spoke with us and said that they had been asked for their consent to live where they did and had been involved in preparing their support plans. One approved carer said, 'My client is very capable of expressing their views and everything we do in the family is with their involvement and agreement'.

We found that people's health and welfare had been supported effectively and that their personal development, independence and community involvement had been promoted. One person told us, 'I go into the centre a lot and can go into town on my own. I don't worry about the bad weather. I can always put a brolly up'.

We found the service ensured that approved carers had been trained in safeguarding people from abuse and that processes were in place to encourage them and people who used the service to report any concerns. One person said, 'I am completely safe here. If you can find me a better place than this to live I'll give you a fiver'.

We found the provider had published a statement of purpose which contained current information about the scope of the service provided.

We saw that the service had an effective system in place to monitor its compliance and performance. Comments from approved carers and people were responded to appropriately.

At the time of our inspection this service did not have a registered manager.

Two people who used this service spoke with us and confirmed that they had been involved in preparing their care plan and reviewing it regularly. One person said, 'We go through the plan and make changes. It's what I want that's important'.

The service manager told us that approved carer training was vital and said, 'Where it might be useful we invite people using the service along to training sessions too'. This meant that all parties with an interest in maintaining the standards of care and support delivered were involved in training sessions.

We spoke with two approved carers who confirmed that the care and support they provided was regularly reviewed with the service manager. We found that approved carers treated people with dignity and respect and that support plans were tailored to meet people's needs.

We found the service ensured that approved carers had the required level of safeguarding awareness because training was provided. One person told us, 'I feel very safe here it's friendly and a family. I have a front door key and can use it any time'.

We found that people were supported by approved carers who gave advice and enabled them to develop independence to make decisions about their lifestyle, support and care.

We saw that an effective complaints system was in place. People's comments and complaints were responded to appropriately.