Shared Lives Scheme (West Sussex County Council)

Updated 17 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 27 September 2018 and was announced. We told the registered manager 48 hours before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection.

The inspection was undertaken by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience gathered feedback from people by speaking with them over the telephone.

We used information the provider sent us in the Provider Information Return (PIR) to complete the inspection report. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at this and other information we held about the service. This included notifications. Notifications are changes, events or incidents that the service must inform us about.

We spoke with seven people who used the service, six shared lives carers and three relatives. During the inspection we spoke with the registered manager, the quality assurance manager, two senior shared lives workers and a shared lives worker. We also spoke to people using the service who were attending the adjoining day care facility on the day of the inspection. Prior to the inspection we also received feedback from professionals within local authority commissioning teams and transition teams.

We reviewed a range of records about people's care and how the service was managed. These included the care records for five people, recruitment and training records for four shared lives carers and shared lives workers, medicine management records, quality assurance audits, complaints management, incident reports and records relating to the management of the service.

The service was last inspected on the 26 June 2017 and was given the rating of requires improvement. At this inspection the service’s overall rating had improved to good.

Updated 17 November 2018

This comprehensive inspection took place on 26 June 2017 and was announced.

Shared Lives Scheme (West Sussex County Council) is registered to provide personal care and support. The service offers long term and short-term placements for adults and older people living in the West Sussex area, who have a learning disability. People who have a mental health need are also supported when there is a dual diagnosis of a learning disability. People may also have a physical and/or sensory disability. People had access to ‘day share’ facility, where they could go to a shared lives carer for the day. In Shared Lives, an adult over 18 years of age who needs support and or accommodation becomes a regular visitor to, or moves in with, a registered shared lives carer. Together, they share family and community life and in many cases the individual becomes part of a supportive family.

Shared lives carers (SLCs) and people they care for are matched for compatibility and can develop real relationships. The shared lives carer acts as 'extended family', so that someone can live at the heart of their community in a supportive family setting. Not all provided the regulated activity of personal care at the time of the inspection, but may be supporting people with developing access into their local neighbourhood and helping develop people's life skills towards improved independence.

Shared lives carers are supported and managed by staff employed at Shared Lives West Sussex County Council. The provider is responsible for ensuring SLCs are provided with the appropriate knowledge, skills and support to undertake this role. The provider employs Shared Lives Officers (SLOs) to carry out this role. The service operates throughout West Sussex and at the time of inspection provided care and or support to 144 clients from 96 households.

Following the last inspection on 26 June 2017, the service was rated as Required Improvement. At the current inspection, we found that sufficient improvements had been made in the areas of safe and well-led that the services overall rating had improved to Good.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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 staff and shared lives carers showed a genuine and in-depth understanding and compassion for the people they supported. People were treated with high standards of kindness, compassion and respect. Their independence was promoted as far as possible, whilst respecting their choices. There was a very strong emphasis on people having choices and their preferences being respected. People were actively involved in their support and in the recruitment process of other shared lives carers.

Risks to people's personal safety and wellbeing had been assessed and plans were in place to minimise these risks. People were protected against abuse and avoidable harm. People involved in accidents and incidents were supported to stay safe and action was taken to prevent further injury or harm. People’s medicines were safely managed.

Assessments were holistic and took account of people’s diverse and complex needs. People and relatives took part in the interview process for new staff and had an influence over who was recruited. The registered manager ensured there were enough qualified, skilled and knowledgeable staff to meet people's needs. Shared lives staff and carers received training that was bespoke to shared lives arrangements and needs.

Carers were aware of people's individual preferences and patterns of eating and drinking and people were encouraged to improve their life skills and to be involved in the preparation of meals in the shared lives households.

Shared lives staff and shared lives carers worked well together, and with other professionals, to ensure people received effective care and support. Staff followed the requirements of the Mental Capacity Act 2005, only providing care with people's consent. Where they had concerns about someone's ability to give consent to aspects of their care, best interests decisions were recorded so the person's needs were met in the least restrictive way possible.

Care and support was tailored to people's individual needs. People were encouraged and supported to be involved in the care planning and review process. Arrangements for social activities met people's individual needs; there was an emphasis on people living as full a life as possible. Shared lives carers went to great lengths to arrange activities that people really wanted to take part in, based on their interests or expressed wishes.

Complaints procedures were in place and available in formats to support people to raises issues should they need to. The provider used learning from complaints to drive improvements in the service.

People, their relatives, shared lives workers and shared lives carers all spoke positively about the support and management skills of the leadership team. They told us that managers and senior staff were approachable, open and very supportive. The registered manager had a clear vision of the direction of the service and had ensured that a robust and clear quality assurance system was in place. People, their relatives and staff were engaged and involved in the service and the provider worked closely with professionals and agencies to ensure effective support was delivered.