Shared Lives

Shared Lives Gateshead provides personal care to 80 people with a learning disability at the time of the inspection.

Shared Lives Gateshead is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People received good care, from a kind and caring team of shared lives carers.

People and carers said the service was safe. Shared lives carers knew how to report safeguarding and whistle blowing concerns. They confirmed they felt confident to do so. The provider recruited new shared lives carers safely. People received their medicines when they were due. The service logged and investigated incidents and accidents.

Training was up to date and shared lives carers received good support. Shared lives carers supported people to have enough to eat and drink and to access healthcare services.

People were supported to have maximum choice and control of their lives and shared lives carers supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service fully assessed people’s needs which formed the basis for developing personalised care plans. Shared lives carers supported people to follow a wide range of activities and attend events. The provider investigated complaints fully; although these were not directly related to the care provided.

The provider had worked with stakeholders to improve the quality assurance processes. These were now effective in identifying areas for improvement and learning lessons. People, relatives and carers described the registered manager as supportive and approachable. People could provide feedback about the service; their views were listened to and acted on.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 15 November 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Shared Lives Gateshead is a local authority run service, which arranges accommodation and support for people with disabilities who are unable to live independently. This support is provided by suitably qualified shared lives carers (carers), who provide care and accommodation from their own home. The service offers both long term accommodation and a short-break service. Another support option is offered via ‘Hour Lives’ which is day-time flexible support. This flexible option allows carers to support people living in their own homes and out in the community. At the time of our inspection, 64 people received flexible support and 17 people received long-term support.

Shared Lives Gateshead has been developed and designed in line with the values that underpin 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.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

The service is supported by the registered manager, three shared lives workers and one senior shared lives worker, (link workers). Link workers are employed by the provider to provide support and guidance to carers. Up until recently, and for a period of time prior to this inspection, the provider did not have a full complement of shared lives link workers in post.

People we spoke with told us they felt safe living with their carers. Link workers and carers had received training in safeguarding practices. However, the inspection identified shortfalls in training for a number of carers, this training included safeguarding, fire training, food hygiene and mental capacity. Additionally, due to a lack of link worker availability, bi-monthly supervision of carers had not been completed.

The provider had a robust recruitment and approval process in place which culminated in a process which very carefully matched people with their carers.

People were supported to lead their lives to the maximum and to be as independent as possible. Life goals were discussed with people and evidence reviewed supported how well people were working towards achieving those goals.

When we spoke to carers it was clear to see that good bonds and relationships were in place. One person we spoke with told us, “I love living with [Carer]. I used to come here for short-breaks, but I live here all the time now, it’s much better.”

Prior to people living with their carers, a full assessment was carried out regarding their needs. Care plans included a document named ‘All about Me’ and this document included people’s likes/dislikes, what was important to them and how carers should care for them.

The registered manager attended regular shared lives meetings with other local shared lives providers in order to share best practice and to reflect on lessons learnt. The provider is also part of a larger network of shared lives services, (Shared Lives Partnership) and they attended this conference which is held each year. A review of the provider’s documents showed that no formal analysis was in place in relation to accidents and incidents. Additionally, there was a lack of oversight regarding the monitoring of quality and assurance of care delivered. This was due to home visits that had not been carried out by link workers for a number of carers.

At the last inspection in 2016 we rated this service as Good. At this inspection we rated the provider as Requires Improvement. This is the first time the service has been rated as Requires Improvement.

We found one breach in regulation and this was in relation to staffing.

You can see what action we told the provider to take at the back of the full version of the report.

The last inspection was in February 2014 and the service was compliant with the regulations in force at the time.

Shared Lives is a domiciliary care agency which is registered for the regulated activity of personal care. The service recruits, assesses and supports paid carers to support people with disabilities who are unable to live independently. 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. The service also provides care and support to people in their own homes and in the community. At the time of inspection there were 79 people using the service and 49 carers.

There was a registered manager who had been in post since 2010. 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.

Robust processes were followed to recruit and assess people who applied to become shared lives carers, and to review the suitability of the existing carers. There were enough carers to deliver the service safely and people were provided with continuity of care. All carers were given training and support to meet the needs of the people they cared for, including regular opportunities to meet their shared lives link worker.

The shared lives link workers were skilled and experienced in co-ordinating the scheme and were appropriately supported in carrying out their roles. They monitored the placements closely and had a good awareness of how to safeguard people from harm and abuse. The workers promoted personal safety whilst respecting people’s freedom to exercise their independence and take risks. There was effective liaison between link workers and other external professionals to help maintain placements.

Each person was encouraged and supported to make choices and decisions about their care and living arrangements. Where people did not have the mental capacity to make important decisions, the scheme worked with other professionals to check that decisions made were in their best interests. We found that care and support was safely planned to minimise risks to people’s wellbeing.

People were supported to stay healthy, have a balanced diet, and wherever possible, to manage their own medicines. Detailed support and care plans were drawn up which reflected the persons choices and aspirations. People were supported to develop or regain skills and abilities they had lost. People were supported to take part in activities they enjoyed.

People who used the service, their relatives and professionals involved in their care, were happy with the care and support provided. They told us the shared lives carers were kind and caring and treated people with dignity and respect. People were matched with supportive carers who enabled them to lead active lives, take part in enjoyable activities and develop their life skills.

There was a positive culture and the team worked inclusively with people using the service, the shared lives carers, and other professionals. Systems were in place to obtain and act on feedback and make improvements to the quality of the service and learn from incidents. An independent panel had oversight of how the scheme was working to make sure that standards were maintained.

We found evidence that people who used the service were the main priority of carers, social workers and managers and that they were consulted in their care at all levels of involvement with the provider.

We spent time reviewing documentation with the registered manager and found substantial evidence that people who used the service and their carers were safe and that their views and opinions were taken seriously.

We reviewed the complaints procedure with the registered manager and found that there were no ongoing complaints and that minor concerns had been dealt with promptly and appropriately.